Carmelo Luigiano, Milena Di Leo, Marco Magistroni, Giuseppe Iabichino, Monica Arena, Pierluigi Consolo, Maria Angela Palamara, Ludovico Abenavoli, Luca De Luca
{"title":"全覆盖自扩展金属支架治疗肿瘤胃食管手术后渗漏：一项队列研究。","authors":"Carmelo Luigiano, Milena Di Leo, Marco Magistroni, Giuseppe Iabichino, Monica Arena, Pierluigi Consolo, Maria Angela Palamara, Ludovico Abenavoli, Luca De Luca","doi":"10.2174/0115748871324401250114101416","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leakages are one of the most frequent complications of gastroesophageal surgery with a high mortality.</p><p><strong>Objective: </strong>This study aimed to assess the efficacy and safety of endoscopic therapy using fully covered self-expanding metal stents (FC-SEMS) for the management of anastomotic leaks.</p><p><strong>Methods: </strong>In this cohort study, all patients with leak after oncological gastroesophageal surgery treated with FC-SEMS were included. Procedures were performed by one expert endoscopist in three Italian endoscopic units. The primary outcome was clinical success defined as complete resolution of clinical and laboratory manifestations of sepsis with radiological evidence of leak closure. Secondary outcomes were technical success, stent-related adverse events (AEs), and mortality.</p><p><strong>Results: </strong>28 patients (21.4% female, mean age 64.3 years) were included in the study, of whom 17 (60.7%) had undergone total gastrectomy, 9 (32.1%) Ivor-Lewis procedure, and 2 (7.1%) extended gastrectomy (transhiatal-abdominal approach). The leaks were located in esophagogastric anastomosis in 5 patients (17.9%), esophagojejunal anastomosis in 19 (67.9%), and esophagus in 4 (14.3%). A total of 34 stents were placed (mean of 1.2 per patient). Technical success of stent placement was achieved in all cases (100%). Clinical success was observed in 78.6% of patients. Stent-related early AEs occurred in 9 patients (32.1%, all were migration). Late AEs occurred in 21.4%, which all were treated endoscopically.</p><p><strong>Conclusion: </strong>Stenting therapy using FC-SEMS is a safe and effective modality for the management of anastomotic leaks.</p>","PeriodicalId":21174,"journal":{"name":"Reviews on recent clinical trials","volume":" ","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Fully Covered Self-Expandable Metal Stents for the Treatment of Leak after Oncologic Gastroesophageal Surgery: A Cohort Study.\",\"authors\":\"Carmelo Luigiano, Milena Di Leo, Marco Magistroni, Giuseppe Iabichino, Monica Arena, Pierluigi Consolo, Maria Angela Palamara, Ludovico Abenavoli, Luca De Luca\",\"doi\":\"10.2174/0115748871324401250114101416\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Anastomotic leakages are one of the most frequent complications of gastroesophageal surgery with a high mortality.</p><p><strong>Objective: </strong>This study aimed to assess the efficacy and safety of endoscopic therapy using fully covered self-expanding metal stents (FC-SEMS) for the management of anastomotic leaks.</p><p><strong>Methods: </strong>In this cohort study, all patients with leak after oncological gastroesophageal surgery treated with FC-SEMS were included. Procedures were performed by one expert endoscopist in three Italian endoscopic units. The primary outcome was clinical success defined as complete resolution of clinical and laboratory manifestations of sepsis with radiological evidence of leak closure. Secondary outcomes were technical success, stent-related adverse events (AEs), and mortality.</p><p><strong>Results: </strong>28 patients (21.4% female, mean age 64.3 years) were included in the study, of whom 17 (60.7%) had undergone total gastrectomy, 9 (32.1%) Ivor-Lewis procedure, and 2 (7.1%) extended gastrectomy (transhiatal-abdominal approach). The leaks were located in esophagogastric anastomosis in 5 patients (17.9%), esophagojejunal anastomosis in 19 (67.9%), and esophagus in 4 (14.3%). A total of 34 stents were placed (mean of 1.2 per patient). Technical success of stent placement was achieved in all cases (100%). Clinical success was observed in 78.6% of patients. Stent-related early AEs occurred in 9 patients (32.1%, all were migration). 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Fully Covered Self-Expandable Metal Stents for the Treatment of Leak after Oncologic Gastroesophageal Surgery: A Cohort Study.
Background: Anastomotic leakages are one of the most frequent complications of gastroesophageal surgery with a high mortality.
Objective: This study aimed to assess the efficacy and safety of endoscopic therapy using fully covered self-expanding metal stents (FC-SEMS) for the management of anastomotic leaks.
Methods: In this cohort study, all patients with leak after oncological gastroesophageal surgery treated with FC-SEMS were included. Procedures were performed by one expert endoscopist in three Italian endoscopic units. The primary outcome was clinical success defined as complete resolution of clinical and laboratory manifestations of sepsis with radiological evidence of leak closure. Secondary outcomes were technical success, stent-related adverse events (AEs), and mortality.
Results: 28 patients (21.4% female, mean age 64.3 years) were included in the study, of whom 17 (60.7%) had undergone total gastrectomy, 9 (32.1%) Ivor-Lewis procedure, and 2 (7.1%) extended gastrectomy (transhiatal-abdominal approach). The leaks were located in esophagogastric anastomosis in 5 patients (17.9%), esophagojejunal anastomosis in 19 (67.9%), and esophagus in 4 (14.3%). A total of 34 stents were placed (mean of 1.2 per patient). Technical success of stent placement was achieved in all cases (100%). Clinical success was observed in 78.6% of patients. Stent-related early AEs occurred in 9 patients (32.1%, all were migration). Late AEs occurred in 21.4%, which all were treated endoscopically.
Conclusion: Stenting therapy using FC-SEMS is a safe and effective modality for the management of anastomotic leaks.
期刊介绍：
Reviews on Recent Clinical Trials publishes frontier reviews on recent clinical trials of major importance. The journal"s aim is to publish the highest quality review articles in the field. Topics covered include: important Phase I – IV clinical trial studies, clinical investigations at all stages of development and therapeutics. The journal is essential reading for all researchers and clinicians involved in drug therapy and clinical trials.
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