New covered mushroom-shaped metallic stent for managing anastomotic leak after esophagogastrostomy with a wide gastric tube

Purpose. To evaluate the clinical results of a new covered mushroom-shaped metallic stent for managing gastroesophageal anastomotic leak after esophagogastrostomy with a wide gastric tube and gastric pull-up. Description. The stent is a self-expanding prosthesis especially designed for occlusion of the esophago-thoracic anastomotic leaks after esophagogastrostomy. From January 2002 to September 2005, 8 patients with gastroesophageal anastomotic leaks were treated with stents. Information about the technical success of stent placement, definitive closure of leak, stent removal, and complications were obtained. Evaluation. Stent placement was technically successful in all patients, without immediate procedural complications. The stent completely sealed off the fistula in all patients, and 30-day mortality was nil. Follow-ups at 7 to approximately 30 months showed that all leaks were healed without stent-related complications, and the stents were removed after approximately 18 to 48 days. Two patients died, and the remaining 6 patients were alive with no evidence of disease at the time of this report. Conclusions. The use of a new covered mushroom-shaped metallic stent proved expedient, safe, and effective in the treatment of gastroesophageal anastomotic leaks.