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Surgical Endoscopy
Published in: Surgical Endoscopy 7/2004

01-07-2004 | Original article

Results after endoscopic treatment of postoperative upper gastrointestinal fistulas and leaks using combined Vicryl plug and fibrin glue

Authors: S. Truong, G. Böhm, U. Klinge, M. Stumpf, V. Schumpelick

Published in: Surgical Endoscopy | Issue 7/2004

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Abstract

Background

The incidence of clinically relevant anastomotic leaks after upper gastrointestinal surgery is approximately 4% to 20%, and the associated mortality is up to 80%. Depending on the clinical presentation, the treatment options include surgery, conservative treatment with or without external drainage or endoscopic treatment.

Methods

This report presents nine cases of anastomotic leaks or fistulae after surgery for upper gastrointestinal cancers that were treated by insertion of a Vicryl plug and sealing with fibrin glue. Under sedation, all nine patients underwent endoscopic lavage of the cavity at the site of anastomotic leakage. The entrance to the cavity then was filled with Vicryl mesh and sealed off with fibrin glue. After the procedure, the patients underwent endoscopy and a water-soluble contrast study for assessment of the result.

Results

Seven of the nine patients had complete healing of the anastomotic leak or fistula after one to two endoscopic treatments. In one case, the treatment failed immediately because of a large and direct tracheoesophageal fistula. Another patient experienced recurrent intrathoracic abscesses after initial technical success.

Conclusions

Postoperative upper gastrointestinal fistulas or anastomotic leaks can be managed successfully with little morbidity by means of endoscopic insertion of Vicryl mesh with fibrin glue, thereby avoiding repetitive major surgery and its associated risks.
Literature
1.
Cellier, C, Landi, B, Faye, A, Wind, P, Frileux, P, Cugnenc, P-H, Barbier, J-P 1996Upper gastrointestinal tract fistulae: endoscopic obliteration with fibrin sealantGastrointest Endosc44731733PubMed
2.
Dumonceau, J-M, Cremer, M, Lalmand, B, Devière, J 1999Esophageal fistula sealing: choice of stent, practical management, and costGastrointest Endosc497078PubMed
3.
Groitl, H, Horbach, T 1996Endoscopic treatment of anastomosis insufficiency perforation in the esophagus with fibrin glueLangenbecks Arch Chir Suppl Kongressbd113753754PubMed
4.
Lau, W-Y, Leung, K-L, Kwong, K-H, Davey, IC, Robertson, C, Dawson, JJW, Cung, SCS, Li, AKC 1996A randomised study comparing laparoscopic versus open repair of perforated peptic ulcer using suture or sutureless techniqueAnn Surg224131138CrossRefPubMed
5.
Orringer, MB 1991Complications of esophageal resection and reconstructionWaldhausen, JAOrringer, MB eds. Complications in cardiothoracic surgeryMosby Year BookSt. Louis354369
6.
Pross, M, Manger, T, Mirow, I, Lippert, H 1999Die Therapieoptionen postoperativer Fisteln am oberen GastrointestinaltraktZentralbl Chir1244546
7.
Pross, M, Manger, T, Reinheckel, T, Mirow, L, Kunz, D, Lippert, H 2000Endoscopic treatment of clinically symptomatic leaks of thoracic esophageal anastomosesGastrointest Endosc517376PubMed
8.
Segalin, A, Bonavina, L, Lazzerini, M, Ruberto, F, Faranda, C, Peracchia, A 1996Endoscopic management of inveterate esophageal perforations and leaksSurg Endosc10928932CrossRefPubMed
9.
Torre, M, Chiesa, G, Ravini, M, Vercelloni, M, Belloni, PA 1994Endoscopic gluing of bronchopleural fistulaAnn Thorac Surg58901902PubMed
10.
Urschel, JD 1995Esophagogastrostomy anastomotic leaks complicating esophagectomy: a reviewAm J Surg169634640CrossRefPubMed
11.
Willetts, IE, Dudley, NE, Tam, PKH 1998Endoscopic treatment of recurrent tracheo-oesophageal fistulae: long-term resultsPediatr Surg Int13256258CrossRefPubMed
12.
Zmora, O, Mizrahi, N, Rotholtz, N, Pikarsky, AJ, Weiss, EG, Nogueras, JJ, Wexner, SD 2003Fibrin glue sealing in the treatment of perineal fistulasDis Colon Rectum46584589PubMed
Metadata
Title
Results after endoscopic treatment of postoperative upper gastrointestinal fistulas and leaks using combined Vicryl plug and fibrin glue
Authors
S. Truong
G. Böhm
U. Klinge
M. Stumpf
V. Schumpelick
Publication date
01-07-2004
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 7/2004
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-003-8286-7

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