Outcomes of the Use of Fully Covered Esophageal Self-Expandable Stent in the Management of Colorectal Anastomotic Strictures and Leaks

Author:

Cooper Chad J.12,Morales Angel3,Othman Mohamed O.2

Affiliation:

1. Department of Internal Medicine, Texas Tech University Health Sciences Center of El Paso, 4800 Alberta Avenue, El Paso, TX 79905, USA

2. Division of Gastroenterology, Texas Tech University Health Sciences Center of El Paso, 4800 Alberta Avenue, El Paso, TX 79905, USA

3. Department of General Surgery, Texas Tech University Health Sciences Center of El Paso, TX 79905, USA

Abstract

Introduction. Colorectal anastomotic leak or stricture is a dreaded complication leading to significant morbidity and mortality. The novel use of self-expandable metal stents (SEMS) in the management of postoperative colorectal anastomotic leaks or strictures can avoid surgical reintervention. Methods. Retrospective study with particular attention to the indications, operative or postoperative complications, and clinical outcomes of SEMS placement for patients with either a colorectal anastomotic stricture or leak. Results. Eight patients had SEMS (WallFlex stent) for the management of postoperative colorectal anastomotic leak or stricture. Five had a colorectal anastomotic stricture and 3 had a colorectal anastomotic leak. Complete resolution of the anastomotic stricture or leak was achieved in all patients. Three had recurrence of the anastomotic stricture on 3-month flexible sigmoidoscopy follow-up after the initial stent was removed. Two of these patients had a stricture that was technically too difficult to place another stent. Stent migration was noted in 2 patients, one at day 3 and the other at day 14 after stent placement that required a larger 23 mm stent to be placed. Conclusions. The use of SEMS in the management of colorectal anastomotic leaks or strictures is feasible and is associated with high technical and clinical success rate.

Publisher

Hindawi Limited

Subject

Radiology, Nuclear Medicine and imaging

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1. A stent of strength: use of lumen-apposing metal stents (LAMS) for biliary pathologies and other novel applications;Abdominal Radiology;2024-09-10

2. Endoscopic Management of Polyps and Endolumenal Surgery;The ASCRS Textbook of Colon and Rectal Surgery;2021-11-21

3. Anastomotic Complications;The ASCRS Textbook of Colon and Rectal Surgery;2021-11-21

4. Novel Uses of Lumen-apposing Metal Stents;Journal of Clinical Gastroenterology;2021-05-28

5. Uncovered self-expandable metal stents for the treatment of refractory benign colorectal anastomotic stricture;Scientific Reports;2020-11-16

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