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Erschienen in: Surgical Endoscopy 11/2013

01.11.2013

Clinical outcomes of endoscopic and surgical management for postoperative upper gastrointestinal leakage

verfasst von: Seohyun Lee, Ji Yong Ahn, Hwoon-Yong Jung, Jeong Hoon Lee, Kwi-Sook Choi, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Jin-Ho Kim, Beom Su Kim, Jeong Hwan Yook, Sung Tae Oh, Byung Sik Kim, Seungbong Han

Erschienen in: Surgical Endoscopy | Ausgabe 11/2013

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Abstract

Background

The purpose of this study was to evaluate the safety and efficacy of endoscopic therapy, an alternative and less invasive modality for the management of leakage after gastrectomy.

Methods

An electronic database of 35 patients with anastomotic leaks after surgery for stomach cancer that were treated with either an endoscopic procedure or surgery between January 2004 and March 2012 was reviewed. The success rates and safety of both modalities were evaluated.

Results

Endoscopic treatment was performed in 20 patients and surgical treatment in 15 patients. The median time interval between the primary surgery and diagnosis of leakage was 8.0 days (interquartile range, 5.0–14.0 days). Of the 20 patients with endoscopic treatment, technical success was achieved in 19 patients (95 %) with resulting clinical success achieved in all of these 19 patients (100 %). One patient with failed endoscopic management went on to receive surgery. There were no cases of leakage-related deaths after endoscopic treatment. Of the 15 patients with surgical treatment, 5 died due to sepsis, bleeding, or hospital-acquired pneumonia. For diagnosis of leakage, 17 patients from the endoscopy group underwent computed tomography (CT) scanning, which revealed leakages in 3 patients (17.6 %) and occult leakages were subsequently defined at fluoroscopy in all 20 patients. Seven of twelve patients (58.3 %) from the surgical group had leakages diagnosed by CT scan.

Conclusions

Endoscopic treatment can be considered a valuable option for the management of postoperative anastomotic leakage with a high degree of technical feasibility and safety, particularly for leakages that are not excessively large.
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Metadaten
Titel
Clinical outcomes of endoscopic and surgical management for postoperative upper gastrointestinal leakage
verfasst von
Seohyun Lee
Ji Yong Ahn
Hwoon-Yong Jung
Jeong Hoon Lee
Kwi-Sook Choi
Do Hoon Kim
Kee Don Choi
Ho June Song
Gin Hyug Lee
Jin-Ho Kim
Beom Su Kim
Jeong Hwan Yook
Sung Tae Oh
Byung Sik Kim
Seungbong Han
Publikationsdatum
01.11.2013
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 11/2013
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-013-3028-y

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