Yıl: 2019 Cilt: 8 Sayı: 1 Sayfa Aralığı: 175 - 181 Metin Dili: İngilizce İndeks Tarihi: 28-05-2020

Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study

Öz:
INTRODUCTION: Anastomosis leak after radical gastrectomy is a medical emergency and should be treated without delay. Most of the self-expanding metallic stents used for leaks in the literature are endoscopically placed and application with scopy have been mentioned only in a few studies. The aim of this study is to evaluate ourexperience in management of postoperative esophagojejunostomy (OJ) leaks after radical total gastrectomy, to evaluate the safety, efficacy, technical and clinical success of a scopically placed fully covered selfexpanding metallic stents (FCSEMS) and compare these parameters with endoscopically placed stents in the literature.METHODS: A total of 20 patients who underwent TG withgastric cancer and subsequently developed OJ leak for theremaining period between 2014 and 2017 were screenedretrospectively and added to the study. FCSEMSes wereplaced in the interventional radiology unit with scopy.RESULTS: Technical success was evaluated as 100%. Clinical success was measured as 80%. Stent migration was observed in 2 patients (10%). One patient died of sepsis. Mortality rate was evaluated as 5%. There were no procedural complications in the patients. The relationship between clinical success and mortality related factors could not be determined statistically (P > 0,05).DISCUSSION and CONCLUSION: FCSEMS is a safe and effective treatment method that can be safely used without complications.
Anahtar Kelime:

Total Gastrektomi Sonrası Gelişen Özofagojejunal Anastomoz Kaçaklarının Floroskopik Olarak Tam Kaplı Self Ekspandıbl Metalik Stent ile Tedavisi; Tek Merkez Çalışması

Öz:
GİRİŞ ve AMAÇ: Radikal gastrektomi sonrası anastomoz kaçağı medikal olarak acil bir durum olup zaman geçirmeden tedavi edilmelidir. Literatürde kaçaklar için kullanılan parsiyel veya tam kaplı self ekspandıbl metalik stentlerin çoğu endoskopik olarak yerleştirilmiş olup skopik uygulamadan sadece birkaç çalışmada bahsedilmiştir. Bu çalışmanın amacı, radikal total gastrektomi (TG) sonrası postoperatif özofagojejunostomi (ÖJ) kaçaklarının yönetiminde deneyimimizi gözden geçirmek, skopik olarak yerleştirilen tam kaplı self ekspandıbl metalik stent (TKSEMS) kullanımının güvenirlik, etkinlik, teknik ve klinik başarısını değerlendirmek ile literatürde endoskopik olarak yerleştirilmiş stentler ile bu parametrelerin karşılaştırılmasıdır. YÖNTEM ve GEREÇLER: 2014 ve 2017 arasında mide kanseri nedeni ile TG yapılıp sonrasında ÖJ kaçağı gelişen toplam 20 hasta retrospektif olarak tarandı ve çalışmaya dahil edildi. TKSEMS’ ler girişimsel radyoloji ünitesinde skopi eşliğinde yerleştirildi. BULGULAR: Teknik başarı %100 olarak değerlendirildi. Klinik başarı %80 olarak ölçüldü. 2 hastada (%10) stent migrasyonu izlendi. Bir hasta sepsis ve sonucu kaybedildi. Bu sonuca göre mortalite oranı %5 olarak değerlendirildi. Hastalarda işlem ile ilişkili komplikasyon gelişmedi. Klinik başarı ile mortalite ile ilişkili faktörler arasındaki ilişki istatistiksel olarak tespit edilemedi (P > 0,05). TARTIŞMA ve SONUÇ: TG sonrası gelişen ÖJ kaçaklarında floroskopik olarak TKSEMS yerleştirilmesi teknik olarak uyulaması kolay ve major komplikasyon gelişmeksizin güvenle kullanılabilen etkili bir tedavi yöntemidir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA özdemir m, Edis Özdemir F, Tola M, BOSTANCI E (2019). Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study. , 175 - 181.
Chicago özdemir mustafa,Edis Özdemir Fatma Ayça,Tola Muharrem,BOSTANCI Erdal Birol Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study. (2019): 175 - 181.
MLA özdemir mustafa,Edis Özdemir Fatma Ayça,Tola Muharrem,BOSTANCI Erdal Birol Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study. , 2019, ss.175 - 181.
AMA özdemir m,Edis Özdemir F,Tola M,BOSTANCI E Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study. . 2019; 175 - 181.
Vancouver özdemir m,Edis Özdemir F,Tola M,BOSTANCI E Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study. . 2019; 175 - 181.
IEEE özdemir m,Edis Özdemir F,Tola M,BOSTANCI E "Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study." , ss.175 - 181, 2019.
ISNAD özdemir, mustafa vd. "Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study". (2019), 175-181.
APA özdemir m, Edis Özdemir F, Tola M, BOSTANCI E (2019). Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study. Kocaeli Tıp Dergisi, 8(1), 175 - 181.
Chicago özdemir mustafa,Edis Özdemir Fatma Ayça,Tola Muharrem,BOSTANCI Erdal Birol Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study. Kocaeli Tıp Dergisi 8, no.1 (2019): 175 - 181.
MLA özdemir mustafa,Edis Özdemir Fatma Ayça,Tola Muharrem,BOSTANCI Erdal Birol Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study. Kocaeli Tıp Dergisi, vol.8, no.1, 2019, ss.175 - 181.
AMA özdemir m,Edis Özdemir F,Tola M,BOSTANCI E Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study. Kocaeli Tıp Dergisi. 2019; 8(1): 175 - 181.
Vancouver özdemir m,Edis Özdemir F,Tola M,BOSTANCI E Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study. Kocaeli Tıp Dergisi. 2019; 8(1): 175 - 181.
IEEE özdemir m,Edis Özdemir F,Tola M,BOSTANCI E "Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study." Kocaeli Tıp Dergisi, 8, ss.175 - 181, 2019.
ISNAD özdemir, mustafa vd. "Treatment of Esophagojejunal Anastomosis Leaks with Full Covered SelfExpanding Metal Stents after Total Gastrectomy: A One Center Study". Kocaeli Tıp Dergisi 8/1 (2019), 175-181.