Use of Esophageal Stents After Anastomotic Leakage in Surgery for Gastric Adenocarcinoma Case Report and Review of the Literature

Mendoza-Moreno F*¹, Díez-Gago MR², Mínguez-García J¹, Enjuto-Martínez DT¹,Tallón-Iglesias B¹, Solana-Maoño M¹ and Argüello-de-Andrés JM¹

Received: July 4, 2018;   Published: July 12, 2018

DOI: 10.26717/BJSTR.2018.06.001391

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Abstract

Introduction: Radical gastrectomy is the treatment of choice for the treatment of gastric cancer located in the upper third of stomach or in case of diffuse histology or cells in a signet ring. The worst complication after a radical gastrectomy is the leakage of the esophago-jejunal anastomosis, since it considerably increases the morbidity and mortality of the patient.

Case Report: Wedescribe our experience after performing a radical gastrectomy for gastric adenocarcinoma in a patient who developed a leakage of the esophago-jejunal anastomosis in the postoperative period. Although he was reoperated, performing reinforcement of the anastomosis and making a feeding jejunostomy, the dehiscence progressed in the following days until it became almost complete. Then, we proceeded to place a digestive endoprosthesis through gastroscopy with good results, allowing the entire defect to heal and being able to be removed without incidents after 8 weeks.

Discussion: There are several alternatives after a leakage of the esophago-jejunal anastomosis. Surgical options include reinforcement of the defect, resection and new anastomosis and esophageal exclusion. However, these options increase the morbidity and mortality of the patient and may require a second intervention in a second time to re-establish the transit. In recent years, the use of digestive stents placed by endoscopy in patients with anastomotic leakage after gastrectomy has proved to be a valid treatment option in selected patients.

Keywords: Stents; Endoscopy; Radical Gastrectomy; Anastomotic Leakage; Self Expandable Metal Stent

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