Laparogastroscopy—A Transgastric Laparoscopic Approach for Malignant Esophageal Stenosis

Author:

Lupu-Petria Alexandra Delia12ORCID,Sabau Alexandru Dan12,Serban Dragos34ORCID,Trotea Tiberiu34,Maniu Ionela56,Sabau Dan12

Affiliation:

1. Faculty of Medicine, “Lucian Blaga” University Sibiu, 550169 Sibiu, Romania

2. Department of Surgery, Emergency County Hospital, 550245 Sibiu, Romania

3. Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania

4. Fourth Department of Surgery, University Emergency Hospital, 050098 Bucharest, Romania

5. Mathematics and Informatics Department, Faculty of Sciences, Research Center in Informatics and Information Technology, “Lucian Blaga” University Sibiu, 550025 Sibiu, Romania

6. Research Team, Clinical Pediatric Hospital, 550166 Sibiu, Romania

Abstract

This paper presents the laparogastroscopy procedure, a mini-invasive, palliative method as an alternative to gastrostomy to be recommended by gastroenterologists. Laparogastroscopic stenting with endoluminal transtumoral drilling solves the problem of oral nutrition in patients with unresectable esophageal cancer, avoiding percutaneous feeding. The results of this technique are presented in a retrospective analysis of a study group of 63 patients with advanced esophageal carcinoma admitted between January 2015 and December 2020 at Department of General Surgery of Emergency County Hospital Sibiu, Romania, in terms of post-operative morbidity and mortality. The type of stents used were Pezzer prostheses (48.6%), silicone prostheses (31.9%), and self-expanding metal stents (6.9%). Eight patients (12.7%) had fistulas (at admission to the clinic), which were successfully sealed. Post-operative dysphagia was absent in most patients and minimal in 16.6% of patients, so all patients could initiate oral feeding, improving their nutritional status. The average length of hospitalization for all patients was 9.22 ± 5.05 days. The most frequent local complications were restenosis (9.5%), stent displacement (7.9%), and bleeding (4.8%). The mean survival time was 10.75 ± 15.72 months. Laparogastroscopic stenting could be a valuable alternative in palliative esophageal cancer surgery, improving the quality of life and nutritional status in patients unsuitable for endoscopic stenting.

Publisher

MDPI AG

Subject

Health Information Management,Health Informatics,Health Policy,Leadership and Management

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