Endoscopic treatment of esophageal perforations and esophageal anastomotic failures
A.I. IVANOV1,3,4, M.V. BURMISTROV2,3,4, V.A. POPOV2,3,4, E.I. SIGAL1,3,4, А.М. SIGAL1,5
1Republican Clinical Oncologic Dispensary of the Ministry of Health of the Republic of Tatarstan, Kazan
2Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan, Kazan
3 Kazan State Medical Academy — Branch Campus of RMACPE MH Russia, Kazan
4National Medical Research Center for Oncology named after N.N. Blokhin of the Ministry of Health of Russia, Moscow
5Kazan (Volga Region) Federal University, Kazan
Contact details:
Ivanov A.I. — PhD (medicine), Associate Professor of the Department of Endoscopy, General and Endoscopic Surgery, Head of the Department of Endoscopy
Address: 29 Sibirsky tract, Kazan, Russian Federation, 420029, tel. +7-917- 261-92-51, e-mail: a.i.ivanov@inbox.ru
Abstract. Insolvency after esophagectomy remains one of the most difficult complications leading to prolonged hospitalization and often to the death of the patient. Stenting with esophageal insolvency can be used in patients with severe concomitant pathology, as a technology of choice, with low mortality rates, and provides an opportunity to avoid volume traumatic operations in debilitated patients. Stent implantation is also a proven method of treatment choice for various other complications, including iatrogenic perforation.
The article provides a methodology for self-manufacturing a device in order to fix the stent at the level necessary to completely close the defect, and also an overview of world experience is given. The results of treatment with analysis of clinical cases in 11 patients with esophageal anastomosis failure and 1 patient with postoperative focal necrosis of the esophagus wall from 2015 to 2017, using endoscopic technologies such as implantation of coated self-healing metal stents, endoscopic vacuum therapy and clipping, are presented. In eleven of the twelve cases, thanks to the above endoscopic technologies, it was possible to solve the problem of pleurisy and mediastinitis in a short time, and also to improve the life quality of patients.
Key words: stenting, anastomotic failure, esophageal cancer, perforation.
(For citation: Ivanov A.I., Burmistrov M.V., Popov V.A., Sigal E.I., Sigal А.М. Endoscopic treatment of esophageal perforations and esophageal anastomotic failures. Practical medicine. 2019. Vol. 17, № 6 (part 2), P. 74-80)
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