scholarly journals Surgical treatment of a rare complication after endoscopic stent placement for anastomotic leakage after esophageal resection

2017 ◽  
Vol 7 (1) ◽  
pp. 1
Author(s):  
Marjan Klinkert ◽  
Mechteld C de Jong ◽  
Meindert N Sosef ◽  
Annick B van Nunen ◽  
Henricus J Belgers
Keyword(s):  
Surgical Treatment ◽  
Anastomotic Leakage ◽  
Stent Placement ◽  
Rare Complication ◽  
Esophageal Resection ◽  
Endoscopic Stent

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

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3720
Author(s):  
Young-Il Kim ◽  
Chan Gyoo Kim ◽  
Jong Yeul Lee ◽  
Il Ju Choi ◽  
Bang Wool Eom ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Anastomotic Leakage ◽  
Stent Placement ◽  
Proximal Gastrectomy ◽  
Stent Migration ◽  
Covered Stent ◽  
Double Layers ◽  
Stent Group ◽  
Hospitalization Period ◽  
Gastric Cancer Patients

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.

Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT study): a multicenter randomized trial

2010 ◽  
Vol 71 (3) ◽  
pp. 490-499 ◽  
Author(s):  
Suzanne M. Jeurnink ◽  
Ewout W. Steyerberg ◽  
Jeanin E. van Hooft ◽  
Casper H.J. van Eijck ◽  
Matthijs P. Schwartz ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Gastric Outlet Obstruction ◽  
Stent Placement ◽  
Outlet Obstruction ◽  
Endoscopic Stent ◽  
Malignant Gastric Outlet Obstruction ◽  
Multicenter Randomized Trial

scholarly journals International Survey on the Management of Anastomotic Leakage After Esophageal Resection

2018 ◽  
Vol 106 (6) ◽  
pp. 1702-1708 ◽  
Author(s):  
Eliza R.C. Hagens ◽  
Maarten C.J. Anderegg ◽  
Mark I. van Berge Henegouwen ◽  
Suzanne S. Gisbertz
Keyword(s):  
Anastomotic Leakage ◽  
Esophageal Resection ◽  
International Survey

scholarly journals Compartment Syndrome Related to Patient Positioning in the Surgical Treatment of Urolithiasis

2021 ◽  
Author(s):  
Inés Laso-García ◽  
Fernando Arias-Fúnez ◽  
Gemma Duque-Ruiz ◽  
David Díaz-Pérez ◽  
Alberto Artiles-Medina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Compartment Syndrome ◽  
Percutaneous Nephrolithotomy ◽  
Rare Complication ◽  
Patient Positioning ◽  
Lower Limbs ◽  
Urinary Stones ◽  
Ureteral Stones ◽  
Lithotomy Position ◽  
American Society

The incidence of urolithiasis is progressively increasing worldwide, as is the surgical treatment of urinary stones. The most frequent surgery for urolithiasis is ureterorenoscopy, which is performed in the lithotomy position. This position is also used in the endoscopic approach to bladder stones. Lateral decubitus is rarely used in the treatment of urinary stones. In the case of complex kidney stones, the gold standard treatment is percutaneous nephrolithotomy. This surgery has traditionally been performed in the prone position. However, the use of the supine (Valdivia) position is increasing in recent times. Furthermore, the Galdakao-modified supine Valdivia position has been widely used for percutaneous nephrolithotomy since it was described by Ibarluzea et al. in 2007. Treatment of kidney and ureteral stones simultaneously is allowed in both supine positions. In addition, they allow the removal of encrusted stents and the easy placement of double J stents and, in the case of the Galdakao-modified supine Valdivia position, percutaneous nephrostomies. Compartment syndrome is a rare complication in the lithotomy position, but scarcely described in the supine position. This especially applies to the Galdakao-modified supine Valdivia position, in which the lower limbs are in moderate flexion, with the ipsilateral lower limb in a slightly lower position relative to the other. This complication can lead to skin necrosis, myoglobinuric renal failure, amputation, permanent neuromuscular dysfunction, and even death. Risk factors include Body Mass Index, male gender, obesity, increased muscle mass, peripheral vascular disease (advanced age, hypertension, hyperlipidemia and diabetes mellitus), height, lack of operative experience, significant bleeding during surgery, hypothermia, acidemia, combination general-spinal anesthesia, prolonged surgical time, systemic hypotension, ASA (American Society of Anesthesiologists) class or vasoconstrictor drugs. Therefore, compartment syndrome of the leg is a potentially devastating complication that must be suspected and treated through early decompression of the compartment by four compartment fasciotomy. Preventive measures reduce the incidence of this condition.

scholarly journals Tertiary Hyperparathyroidism Secondary to X-linked Hypophosphatemic Rickets

2017 ◽  
Vol 9 (1) ◽  
pp. 24-26
Author(s):  
Jose Maria Fernandez Cebrian ◽  
Enrique Colás Ruiz ◽  
Laura Vega ◽  
Santiago Linacero ◽  
Edgardo Celi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Rare Complication ◽  
Hypophosphatemic Rickets ◽  
Tertiary Hyperparathyroidism

ABSTRACT Tertiary hyperparathyroidism is a rare complication of X-linked hypophosphatemic rickets. The surgical treatment is already unclear. How to cite this article Ruiz EC, Cebrián JMF, Vega L, Linacero S, Celi E, Quintáns A. Tertiary Hyperparathyroidism Secondary to X-linked Hypophosphatemic Rickets. World J Endoc Surg 2017;9(1):24-26.

scholarly journals Rekanalizacija striktura uretre privremenim prekrivenim biokompatibilnim metalnim endoprotezama nove generacije

2007 ◽  
Vol 54 (3) ◽  
pp. 123-127 ◽  
Author(s):  
Z. Markovic ◽  
B.B. Markovic ◽  
C. Tulic ◽  
J. Hadzi-Djokic ◽  
V. Stojanovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Urethral Stricture ◽  
Stent Placement ◽  
Clinical Issue ◽  
Urethral Strictures ◽  
Therapeutic Algorithm ◽  
Common Etiology ◽  
Previously Treated ◽  
First Time

The male urethral stricture treatment is actual clinical issue with its resolution being increasingly frequently based on application of minimum invasive therapeutic interventional uroradiology methods. Since the methodology is applied over the last two decades, the most reasonable therapeutic algorithm has not been defined yet with respect to the correlation with the contemporary surgical treatment. The results of application of the temporary covered self-expandable nitinol Allium stents, which have been applied for the first time ever at our Institution in October 2003. Over the last 3 years, the method was applied in 40 males, averagely aged 54 years with urethral strictures previously treated by urological methods. In four cases, stent placement was performed after endourethral incision. The most common etiology of the stricture was the posttraumatic (55 %), post-inflammatory (32%) and iatrogenic (10%). In all the cases, stents were removed 12-14 months after their insertions. The results are evaluated using uroflowmetry and urethrocystography, revealing in 85% of the cases permanent recanalization free of dysuric complaints. Development of a stricture on the anterior stent end was evidenced in 15% of the cases.

scholarly journals Endoscopic stent insertion for anastomotic leakage following oesophagectomy

2013 ◽  
Vol 95 (1) ◽  
pp. 43-47 ◽  
Author(s):  
M Schweigert ◽  
N Solymosi ◽  
A Dubecz ◽  
RJ Stadlhuber ◽  
H Muschweck ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Stent Implantation ◽  
Fatal Outcome ◽  
Invasive Procedure ◽  
High Volume ◽  
Primary Treatment ◽  
Stent Insertion ◽  
Endoscopic Stent ◽  
Life Threatening ◽  
Life Threatening Complication

Introduction Intrathoracic anastomotic leakage following oesophagectomy is a crushing condition. Until recently, surgical re-exploration was the preferred way of dealing with this life threatening complication. However, mortality remained significant. We therefore adopted endoscopic stent implantation as the primary treatment option. The aim of this study was to investigate the feasibility and results of endoscopic stent implantation as well as potential hazards and pitfalls. Methods Between January 2004 and December 2011, 292 consecutive patients who underwent an oesophagectomy at a single high volume centre dedicated to oesophageal surgery were included in this retrospective study. Overall, 38 cases with anastomotic leakage were identified and analysed. Results A total of 22 patients received endoscopic stent implantation as primary treatment whereas a rethoracotomy was mandatory in 15 cases. There were no significant differences in age, frequency of neoadjuvant therapy or ASA grade between cases with and without a leak. However, patients with a leak were five times more likely to have a fatal outcome (odds ratio: 5.10, 95% confidence interval: 2.06–12.33, p<0.001). Stent migration occurred but endoscopic reintervention was feasible. In 17 patients (77%) definite closure and healing of the leak was achieved, and the stent was removed subsequently. Two patients died owing to severe sepsis despite sufficient stent placement. Moreover, stent related aortic erosion with consecutive fatal haemorrhage occurred in three cases. Conclusions Stent implantation for intrathoracic oesophageal anastomotic leaks is feasible and compares favourably with surgical re-exploration. It is an easily available, minimally invasive procedure that may reduce leak related mortality. However, it puts the already well-known risk of stent-related vascular erosion on the spot. Awareness of this life threatening complication is therefore mandatory.

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