Year 2018 / Volume 110 / Number 4
Letter to the Editor
Intrathoracic leak after an Ivor Lewis procedure for an esophageal neoplasm treated with a stent

267-268

DOI: 10.17235/reed.2018.5161/2017

Natalia Afonso Luis, María Asunción Acosta Mérida, Joaquín Marchena Gómez,

Abstract
A 75-year-old male who underwent an Ivor Lewis esophagectomy due to a distal adenocarcinoma had a leak at the gastroplasty on the 5th day after surgery, which required two surgeries and a primary suture. He was transferred to our hospital due to a poor outcome and endoscopy revealed a 2.5cm gap perianastomotically on the gastroplasty wall, for which a stent was placed. Due to hemodynamic impairment, a thoracotomy procedure was performed, which revealed stent protrusion into the cavity. The patient underwent an esophagogastric anastomosis resection, cervical esophagostomy and gastrostomy. Sepsis was resolved postoperatively and the patient had a protracted stay in the PACU due to poor respiratory dynamics following a prolonged intubation.
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References
Self-expanding metal stents in postoperative esophageal leaks. Rodrigues-Pinto E, Pereira P, Ribeiro A, Moutinho-Ribeiro P, Lopes S, Macedo G. Rev Esp Enferm Dig. 2016 Mar;108(3):133-7.
Fully covered metal stents for the treatment of leaks after gastric and esophageal surgery.Fernández A, González-Carrera V, González-Portela C, Carmona A, de-la-Iglesia M, Vázquez S.Rev Esp Enferm Dig. 2015 Oct;107(10):608-13.doi:10.17235/reed.2015.3765/2015. )
Kim RH, Takabe K. Methods of esophagogastric anastomoses following esophagectomy for cancer: a systematic review. J Surg Oncol. 2010;101:527–33.
Kauer W, Stein H, Dirtier H, et al. Stent implantation as a treatment option in patients with thoracic anastomotic leaks after esophagectomy. Surg Endose 2008; 22: 50-53.
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Afonso Luis N, Acosta Mérida M, Marchena Gómez J. Intrathoracic leak after an Ivor Lewis procedure for an esophageal neoplasm treated with a stent. 5161/2017


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Publication history

Received: 06/07/2017

Accepted: 15/12/2017

Online First: 09/02/2018

Published: 02/04/2018

Article Online First time: 218 days

Article editing time: 270 days


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