Ces radiol. 2017, 71(2):146-150 | DOI: 10.55095/CesRadiol2017/019

Treatment of benign esophageal fistulae with covered biodegradable stents - seven-year experienceOriginal article

Martin Köcher¹, Marie Černá¹, Vojtěch Prášil¹, René Aujesky², Martin Hazlinger¹

¹ Radiologická klinika LF a FN, Olomouc

² I. chirurgická klinika LF a FN, Olomouc

Aim: The cause of the esophageal fistula can be ether anastomotic leak after upper gastrointestinal tract operation or esophageal perforation and it is life-threatening condition. The aim of our article is to evaluate our updated experience and results with the treatment of post-operative anastomotic leaks and benign esophageal perforations with covered biodegradable stents.

Methods: From 2009 to 2016 we treated 26 patients with either an anastomotic leak or benign esophageal perforation by implantation of covered biodegradable Ella DV-C stents. Diagnosis and follow-up examinations to evaluate success of fistula sealing and healing were made with water-soluble contrast agent swallow examination.

Results: Forty covered biodegradable stents were implanted in 26 patients. Primary technical success was 100%. Overall clinical success - (leak sealing and healing) - was in group of 26 patients 57.7 %. In subgroup of patients with localized leakage clinical success was achieved in 11 patients (91.7%). In subgroup of patients with massive leakage with or without esophagopleural or esophagoperitoneal fistula clinical success was achieved in 4 patients (28.6%) only.

Conclusions: The use of covered biodegradable stents allow healing of the anastomotic leaks or esophageal perforations during normal food intake without their subsequent removal. Their effectiveness in the treatment of localized anastomotic leaks or esophageal perforations is high. In patients with massive leakage with or without esophagopleural or esophagoperitoneal, despite of worse clinical success, covered biodegradable stents implantation makes subsequent surgery less risky.

Keywords: esophageal fistula, esophageal perforation, stent, biodegradable stent

Grants and funding:

Podpořeno MZ ČR - RVO (LF UP 61989592) a MZ - ČR RVO (FN OL 00098892).

Accepted: March 30, 2017; Published: June 1, 2017  Show citation