Nonoperative Treatment of 15 Benign Esophageal Perforations With Self-Expandable Covered Metal Stents

2006 ◽  
Vol 81 (2) ◽  
pp. 467-472 ◽  
Author(s):  
Andreas Fischer ◽  
Oliver Thomusch ◽  
Stefan Benz ◽  
Ernst von Dobschuetz ◽  
Peter Baier ◽  
...  
2007 ◽  
Vol 20 (5) ◽  
pp. 444-448 ◽  
Author(s):  
A. Fischer ◽  
H. J. Schrag ◽  
M. Goos ◽  
E. Von Dobschuetz ◽  
U. T. Hopt

2010 ◽  
Vol 71 (5) ◽  
pp. AB313-AB314 ◽  
Author(s):  
Petra Van Boeckel ◽  
Kulwinder S. Dua ◽  
Ruben Schmits ◽  
Sri Naveen Surapaneni ◽  
Frank P. Vleggaar ◽  
...  

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 72-72
Author(s):  
Albert Caballero ◽  
Marta Viciano ◽  
Elisenda Garsot ◽  
Marta Arnau ◽  
Joan Francesc Julian

Abstract Background Esophagus perforations are one of the most severe lesions of the digestive tract. Until now the treatment continues to be controversial, with mortality greater than 30% of cases, mainly with a thoracic location. Severity is determinate by the progression of infection due to anatomical characteristics of the mediastinum. The location, size of the perforation and the evolution time determine the treatment to follow. In order to assess the results obtained and the different management options we present a series of 9 patients, with benign esophageal perforations, treated in our center during the last 5 years. Methods We designed an observational study in which we identify retrospectively the results of our series during the last five years (From 2013 to 2018). We analysed the following variables: Characteristics of patients, medical and surgical management, morbidity and mortality Results In all series, 5 of 9 patients received surgical treatment (55,5%), In the remaining three cases, simple suture and placement of drainages was performed. Conservative treatment was the first management attempt in the last four cases (44,5%), all of them due to impaction of food bolus or foreign body. Of all series evolved favourably with a non-negligible morbidity and continued ambulatory follow up. There was no mortality. Conclusion It is difficult to establish a protocol of action in patients with esophageal perforation. We have obtained good results by individualizing each case and adjusting the type of treatment to the needs of each patient, from a conservative attitude to radical surgery. Disclosure All authors have declared no conflicts of interest.


2020 ◽  
pp. 145749692096099
Author(s):  
M. Waltersten ◽  
M. Sundbom

Background and aims: Esophageal perforations are life threatening. Since the 1990s, placing of covered esophageal stents has become an alternative to surgery. Theoretically, this minimally invasive approach has several benefits; however, little data are available on long-term outcome in these patients. We aimed to evaluate how patient-reported outcome differed between full surgery and placement of self-expanding metallic stents when treating primary benign esophageal perforations. Material and methods: Of 48 patients treated at our hospital in 2000–2015, 23 were alive and asked to answer three questionnaires. We used a short clinical questionnaire, the QLQ-OG25 from the European Organization for Research and Treatment of Cancer and a simplified quality-of-life instrument, the Check Your Health. Non-parametric statistics were used to evaluate differences between the two groups. Results: In all, 20 (87%) individuals (13 men, 64 years of age) responded. At survey, surgical patients had lost 13 kg of initial weight, compared to no weight loss in the self-expanding metallic stents group (p = 0.01). This involuntary weight loss worried patients according to the QLQ-OG25; otherwise patient-experience measures did not differ between groups. For quality of life, surgical patients scored significantly lower physical health, emotional well-being, social functioning, and overall quality of life after treatment, but after stenting no differences were seen. Conclusions: In contrast to stenting, surgical treatment was associated with involuntary, and worrisome, weight loss as well as reduced quality of life. We therefore believe that self-expanding metallic stents should be used when possible in treating benign esophageal perforations.


2014 ◽  
Vol 259 (5) ◽  
pp. 852-860 ◽  
Author(s):  
Bobby V.M. Dasari ◽  
David Neely ◽  
Andrew Kennedy ◽  
Gary Spence ◽  
Paul Rice ◽  
...  

2011 ◽  
Vol 02 (01) ◽  
pp. 009-014 ◽  
Author(s):  
Kulwinder S Dua

ABSTRACTEsophageal cancer is often diagnosed at a late stage and hence carries a poor prognosis with an overall 5-year survival rate of 10% to 15%. Therefore, palliative treatment primarily aimed at the relieving dysphagia is the only available option. Endoscopic placement of self expanding metal stents (SEMS) has become a widely used method for palliation offering prompt relief of dysphagia and numerous reports have shown it to be safe and effective. Secondary to tissue in-growth into the uncovered segments of the stent, SEMS cannot be removed and hence are not approved for benign indications. With the advent of the removable self expanding plastic stents, the indications for esophageal stent insertion have expanded to as bridge to surgery for patients undergoing neoadjuvant chemotherapy, for refractory benign esophageal strictures, for non- malignant esophageal perforations, leaks and fistulae, and even for variceal hemorrhage. Newer fully covered SEMS that are potentially removable are also being tried for benign indications but await FDA clearance. Similarly biodegradeable stents for benign disorders and radioactive or drug-eluding stents for malignant disease are hoped to improve the management of esophageal diseases. The purpose of this article is to review the expanding role of self expanding stents in the management of esophageal disorders other than palliating malignant dysphagia and fistulae.(J Dig Endos 2011;2(1):9-14)


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