Endoscopic filling with polyglycolic acid sheets and fibrin glue of persistent fistula after esophagectomy.


Journal

Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166

Informations de publication

Date de publication:
03 2021
Historique:
aheadofprint: 16 06 2020
pubmed: 17 6 2020
medline: 27 4 2021
entrez: 17 6 2020
Statut: ppublish

Résumé

Treatment of anastomotic leakage in reconstruction after esophagectomy remains challenging. This report presents a new endoscopic filling method for persistent fistula after failure of conservative treatment of leakage caused by anastomotic insufficiency. 10 of 14 patients, in whom post-esophagectomy leakage had failed to resolve after 2 weeks of conservative treatment, underwent endoscopic filling with polyglycolic acid (PGA) sheet and fibrin glue into the anastomotic leakage site, using a delivery tube and endoscopic catheter, respectively. Each patient underwent jejunostomy, to secure nutrition. The leakage was resolved in all 10 patients. The mean number of PGA - fibrin glue procedures was 1.7. The mean period from the first application to the resumption of oral intake was 31.6 days, from the final application it was 14.7 days. The reported filling method offers a new endoscopic approach for persistent fistula after esophagectomy when conservative treatment of leakage has failed.

Sections du résumé

BACKGROUND
Treatment of anastomotic leakage in reconstruction after esophagectomy remains challenging. This report presents a new endoscopic filling method for persistent fistula after failure of conservative treatment of leakage caused by anastomotic insufficiency.
METHODS
10 of 14 patients, in whom post-esophagectomy leakage had failed to resolve after 2 weeks of conservative treatment, underwent endoscopic filling with polyglycolic acid (PGA) sheet and fibrin glue into the anastomotic leakage site, using a delivery tube and endoscopic catheter, respectively.
RESULTS
Each patient underwent jejunostomy, to secure nutrition. The leakage was resolved in all 10 patients. The mean number of PGA - fibrin glue procedures was 1.7. The mean period from the first application to the resumption of oral intake was 31.6 days, from the final application it was 14.7 days.
CONCLUSIONS
The reported filling method offers a new endoscopic approach for persistent fistula after esophagectomy when conservative treatment of leakage has failed.

Identifiants

pubmed: 32544956
doi: 10.1055/a-1200-8199
doi:

Substances chimiques

Fibrin Tissue Adhesive 0
Tissue Adhesives 0
Polyglycolic Acid 26009-03-0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

288-292

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest.

Auteurs

Kousei Tashiro (K)

Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan.

Shinsuke Takeno (S)

Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan.

Fumiaki Kawano (F)

Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan.

Eiji Kitamura (E)

Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan.

Rouko Hamada (R)

Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan.

Makoto Ikenoue (M)

Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan.

Shun Munakata (S)

Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan.

Atsushi Nanashima (A)

Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan.

Kunihide Nakamura (K)

Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan.

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Classifications MeSH