Effectiveness of a Novel Covered Stent without External Thread Fixation for Anastomotic Leakage after Total or Proximal Gastrectomy for Gastric Cancer

Abstract

A thread-fix stent entails long hospitalization and patient discomfort. We aimed to evaluate the efficacy of a novel stent with silicone-covered outer double layers without external fixation (Beta stent) for anastomotic leakage after total or proximal gastrectomy. The outcomes were compared between gastric cancer patients who underwent stent placement using a thread-fix stent between 2014 and 2015 (Thread-Fix Group) and those who received a Beta stent in the succeeding period until October 2018 (Beta Stent Group). The Beta Stent Group (n = 14) had a significantly higher leakage healing rate by the first stent placement (92.9% vs. 53.8%; p = 0.021) and had a shorter hospitalization period (median: 16 days vs. 28 days; p = 0.037) than the Thread-Fix Group (n = 13). Further, 50% of the Beta stent patients received outpatient management until stent removal. Stent maintenance duration was significantly longer in the Beta Stent Group (median, 28 days vs. 18 days; p = 0.006). There was no significant between-group difference in stent-related complications except for stent migration (7.1% (Beta Stent Group) vs. 0% (Thread-Fix Group), p = 0.326). In conclusion, the Niti-S Beta stent is an effective treatment for anastomotic leakage from total or proximal gastrectomy for gastric cancer. Stent maintenance is possible without hospitalization.

Successful treatment of an anastomotic leakage after total gastrectomy using a fully covered self-expandable metal stent with an anchoring thread: A case report

“…Curcio et al reported the efficacy of endoscopic stents for anastomotic leakage after esophagojejunostomy following total gastrectomy in 2010 [ 19 ]. In the past, Ultraflex Stents or plastic stents were used; in recent years, however, HANAROSTENT® or Niti-S™ has been used in the reported cases [ 10 , 20 ]. A feature of these stents is that the diameters of both ends are slightly larger than that of the center, providing a structure that is highly adherent to the esophageal lumen and does not easily migrate.…”

Anastomotic Leakage after Gastrectomy for Gastric Cancer

“…The "Niti-S Beta" stent is a novel stent designed to minimize the risk of stent migration and to simplify the removal of stents for leakage or fistula after bariatric surgery. They have 92% healing rate from the first stent placement, higher than for thread-fix stents (53.8%), with a 7% migration rate [84].…”

Innovative Upper Gastrointestinal Stenting: Reboring the Blocked Path

“…The stent migration rate was 13% for conventional stents with clips and 17% for suture fixation. 25 On the other hand, another retrospective study investigating the use of Beta oesophageal stents in staple line leaks showed a migration rate of 32%, with no significant decrease in the stent migration rates. 26 In this case, despite using an anti-migratory stent, the stent migrated distally after 8 weeks.…”