Effect of Early Use of Covered Self-Expandable Endoscopic Stent on the Treatment of Postoperative Stapler Line Leaks

Quezada, Nicolás; Maíz, Cristóbal; Daroch, David; Funke, Ricardo; Sharp, Allan; Boza, Camilo; Pimentel, Fernando

doi:10.1007/s11695-015-1622-x

Cited by 40 publications

(22 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the novel double-bump structure of the Beta stent, which has specifically been designed to prevent migration, migration occurred in 32% of patients (26% of stents) in this study. This seems comparable to the results of other fully covered stents, with a migration rate of 18–67% in previous studies [8, 11, 16, 17, 19, 20]. Partially covered stents are less prone to migration with a migration rate of 5–15% [7, 10, 14, 15, 18].…”

Section: Discussionsupporting

confidence: 88%

A novel fully covered double-bump stent for staple line leaks after bariatric surgery: a retrospective analysis

et al. 2018

View full text Add to dashboard Cite

BackgroundStaple line leakage after bariatric surgery can be treated by endoscopic placement of a self-expandable stent. The success rate of stent placement is generally high, but migration is a frequent adverse event that hampers successful treatment. The Niti-S Beta stent is a fully covered double-bump stent that was specifically designed to prevent migration. This study aimed to evaluate the effectiveness and adverse event rate of the Niti-S Beta stent.MethodsA retrospective study was performed in three high-volume bariatric centers. All consecutive patients between 2009 and 2016 who underwent placement of a Beta stent for staple line leakage were included. Primary outcome was resolution of the leakage; secondary outcome was the adverse event rate including migration.ResultsThirty-eight patients were included. Twenty-five (66%) had resolution of the leakage. Success rate was higher in patients who were treated with implantation of a Beta stent as initial treatment (100%) than in patients who were treated with a stent after revisional surgery had failed (55%, p = 0.013). Migration occurred in 12 patients (32%). There were two severe adverse events requiring surgical intervention, including a bleeding from an aorto-esophageal fistula.ConclusionsThe success rate and the migration rate of the Beta stent seem comparable to other stents in this retrospective study. Despite the novel double-bump structure of the stent, the migration rate does not seem to be decreased.

show abstract

Section: Discussionsupporting

confidence: 88%

A novel fully covered double-bump stent for staple line leaks after bariatric surgery: a retrospective analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Gastric leaks after laparoscopic sleeve gastrectomy (LSG) have proven to be a disastrous complication resulting in longer hospital stays and the need to use a number of modalities for rescue [1][2][3][4][5][6]. The LSG procedure has flourished [7,8], bringing about the decline of leak rates from the procedure while making the resolution of such leaks a larger concern for all surgeons dealing with LSG patients during the postoperative period.…”

mentioning

confidence: 99%

“…Options for management-including reoperation [1,3,4,9,10], endoscopic management with clips or stents [5,6,11], Over-Stitch [12], and other modalities [13,14]-have had good outcomes. There has been no evidence in the literature of use of endoluminal vacuum (E-Vac) therapy for LSG leaks; however, E-Vac therapy has been used with good results for a variety of foregut leaks and perforations, and in some cases, better results than with the use of stents [15][16][17][18][19].…”

mentioning

confidence: 99%

Management of gastric leaks after sleeve gastrectomy with endoluminal vacuum (E-Vac) therapy

Leeds

Burdick

2016

Surgery for Obesity and Related Diseases

107

View full text Add to dashboard Cite

“…The duration of stent treatment has not been standardized, but 6–8 weeks appears to be the optimal time for stent removal because a shorter interval leads to incomplete leak closure and a longer interval may lead to stent migration or mucosal hypertrophy associated with increased difficulty of stent extraction [9]. Earlier stent treatment has been found to be associated with increased success and shorter healing time [14–17]. We also found that successful removal of the stent as early as 3 weeks after stent placement was achieved in three patients who experienced only a small leak.…”

Section: Discussionmentioning

confidence: 82%

Endoluminal stenting for the management of leak following sleeve gastrectomy and loop duodenojejunal bypass with sleeve gastrectomy

Tsai

Wang

Huang

et al. 2017

The Kaohsiung J of Med Scie

View full text Add to dashboard Cite

Postoperative leak is a serious complication of bariatric surgery and often results in significant morbidity and mortality. Stent placement is a less invasive alternative to surgery for the treatment of bariatric surgical leak. We evaluated the efficacy and complications of covered self-expandable metal stents (SEMS) in the treatment of post-bariatric surgical leak. We retrospectively reviewed patients who underwent stent placement for leak after bariatric surgery. Leak was diagnosed by upper gastrointestinal series or was visualized during the endoscopy. We examined the timing of stent placement, size of the leak, stent migration and its complications, total stent treatment duration, and treatment outcome. Between January 2011 and April 2015, seven patients underwent covered SEMS placement for leak after bariatric surgery, including laparoscopic sleeve gastrectomy (LSG) (n = 5) and laparoscopic loop duodenojejunal bypass with sleeve gastrectomy (LDJB-SG) (n = 2). A stent was placed in one patient for infection control and bridging to revisional surgery. Among the other six patients, one patient who received stent placement one year after leak diagnosis failed to achieve leak closure, and five patients with early stent placement achieved leak closure. Three patients with small leak achieved leak closure more quickly. Stent migration was found in six patients, and associated ulcers occurred in five patients. We conclude that stenting is effective in the management of staple-line leaks following LSG and LDJB-SG. Stent migration and associated ulcers are common after stent placement. Early stent removal can be achieved in patients with small leaks.

show abstract

Effect of Early Use of Covered Self-Expandable Endoscopic Stent on the Treatment of Postoperative Stapler Line Leaks

Abstract: SEES is a feasible, safe, and effective management of post BS leaks, although patients may also require prosthesis revision and abdominal exploration. Primary SEES placement is associated with a shorter leak resolution time.

Cited by 40 publications

References 29 publications

A novel fully covered double-bump stent for staple line leaks after bariatric surgery: a retrospective analysis

A novel fully covered double-bump stent for staple line leaks after bariatric surgery: a retrospective analysis

Management of gastric leaks after sleeve gastrectomy with endoluminal vacuum (E-Vac) therapy

Endoluminal stenting for the management of leak following sleeve gastrectomy and loop duodenojejunal bypass with sleeve gastrectomy

Contact Info

Product

Resources

About