Original articleClinical endoscopyTreatment of esophageal leaks, fistulae, and perforations with temporary stents: evaluation of efficacy, adverse events, and factors associated with successful outcomes
Section snippets
Study design and patient selection
This retrospective, single-center study was approved by the Institutional Review Board at Indiana University Medical Center. The Indiana University Hospital endoscopic database was queried for all patients (aged ≥ 18 year old) who had stent placement for esophageal or gastroesophageal junction (GEJ) leaks (postoperative dehiscence), fistulae (benign or malignant, infectious or inflammatory), and perforations (iatrogenic or spontaneous) between January 2003 and May 2012. Patients with L/F/P
Results
Sixty-seven patients with 132 attempted stents placed for L/F/P at the esophagus or GEJ were initially considered for the study. Thirteen patients (11 fistulae, 1 leak, and 1 perforation) were excluded for the following reasons: (1) 5 returned to their referring physicians after stent placement and were lost to follow-up; (2) 6 died of non-stent–related causes (5 patients [3 with fistulae, 1 with a leak, and 1 with a perforation] died from sepsis and/or multiorgan failure and in whom stent
Discussion
Surgical management of esophageal L/F/P is associated with significant morbidity and mortality. Therefore, temporary esophageal stents have been increasingly used as a minimally invasive alternative despite a lack of clearance by the U.S. Food and Drug Administration for this indication.1, 2 This study expands the growing literature on the use of temporary stents for these conditions and summarizes our single-center experience treating a heterogeneous group of patients.
We found that in patients
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.