Endoscopic treatment of postoperative esophagojejunostomy leak

Yıl 2009, Cilt: 17 Sayı: 1, - , 01.04.2009

Mehmet İbiş Erkan Parlak

Öz

Postoperative anastomotic leaks are rare after gastrointestinal system surgery. Their reoperation processes are usually very difficult and risky and as a result, non-invasive methods for this purpose have gained in importance in recent years. Endoscopic treatments are among the most important options for meeting this goal. We describe a case of early postoperative anastomotic leak after total gastrectomy with esophagojejunostomy, successfully managed by using endoclips.

Anahtar Kelimeler

Endoscopy, clip application, esophagojejunostomy

Postoperatif özofagojejunostomi kaçağının endoskopik yolla tedavisi

Öz

Gastrointestinal sistem cerrahisinde postoperatif anastomoz kaçaklarına nadiren rastlanmaktadır. Bunların reoperasyonu oldukça zor ve riskli bir işlemdir. Bu nedenle noninvaziv yöntemlerle tedavi son dönemlerde önem kazanmıştır. Endoskopik tedavi seçenekleri bu amacı karşılayan en önemli işlemlerden biridir. Burada total gastrektomi ve özofagojejunostomi yapılan bir olguda erken anastomoz kaçağının başarılı şekilde endoskopik klip ile tedavisi sunulmuştur.

Anahtar Kelimeler

Endoskopi, klip uygulaması, özofagojejunostomi

Kaynakça

• Hatashi T, Yonezawa M, Kawabara T. The study on staunch clip for the treatment by endoscopy. Gastroenterol Endosc 1975;17:92-101.
• Hachisu T. Evalution of endoscopic hemostasis using an improved clip- ping apparatus. Surg Endosc 1988;2:13-7.
• Hachisu T, Miyazaki S, Hamaguchi K. Endoskopic clip-marking of lesions using the newly development HX-3L clip. Surg Endosc 1989;3:142-7.
• Masaki E, Masaaki I, Ttorahiko T et al. New endoscopic technique to clo- se large mucosal defects after endoscopic mucosal resection in patients with gastric mucosal tumors. Digestive Endoscopy 2004;6: 372-5.
• Cipolletta L, Bianco MA, Rotondano G, et al. Endoscopic clipping of per- foration following pneumatic dilation of esophagojejunal anastomotic strictures. Endoscopy 2000;32:720-2.
• Qadeer MA, Dumot JA, Vargo JJ et al. Endoscopic clips for closing esop- hageal perforations: case report and pooled analysis. Gastrointest Endosc 2007;66:605-11.
• Ohri SK, Liakakos TA, Pathi V, et al. Primary repair of iatrogenic thora- cic esophageal perforation and Boerhaave’s syndrome. Ann Thorac Surg 1993;55: 603-6.
• Gutierrez San Roman C, Barrios JE, Lluna J, et al. Long-term assessment of the treatment of recurrent tracheoesophageal fistula with fibrin glue associated with diathermy. J Pediatr Surg 2006;41: 1870-3.
• Messmann H, Schmidbaur W, Jackle J, et al. Endoscopic and surgical management of leakage and mediastinitis after esophageal surgery.Best Pract Res Clin Gastroenterol 2004;18:809-27.