EXPERIENCE IN THE TREATMENT OF ESOPHAGEAL ANASTOMOSIS LEAK AND POSTOPERATIVE PERFORATION OF THE ESOPHAGUS USING ENDOSCOPIC TECHNOLOGIES

V.Yu. Muravev1-3, A.I. Ivanov1-3, E.I. Sigal1-3, M.V. Burmistrov1-3, V.A. Popov2, A.M. Sigal1, I.M. Sayfutdinov4, A.P. Maksimov1

1Tatarstan Саnсеr Center, Kazan

2Kazan State Medical Academy — Branch of the FSBEI FPE RMACPE MOH Russia, Kazan

3Volga Region branch of N.N. Blokhin Russian Cancer Research Center, Kazan

4Interregional Clinical Diagnostic Center, Kazan

Popov V.A. ― postgraduate student of the Department of Endoscopy, General and Endoscopic Surgery of Kazan State Medical Academy — Branch of the FSBEI FPE RMACPE MOH Russia

29 Sibirskiy Trakt, Kazan, Russian Federation, 420029, tel.: (843) 519-26-31, +7-987-269-33-96, e-mail: lyapac@mail.ru

Abstract. Еsophageal anastomosis leak after esophagectomy remains one of the most difficult complications leading to continued hospitalization and often to the death of the patient. Stenting with esophageal anastomosis leak can be used in patients with significant concomitant pathology, as a technology of choice, with low mortality rates, which allows avoiding large-scale traumatic operations in weakened patients. Stent implantation is also a proven method of treatment choice for various other complications, including iatrogenic perforation.

The technique of independent manufacturing of the device with the purpose of fixing the stent at the level necessary for complete closure of the defect is given in the article , and also the review of world experience is presented  . The results of treatment with analysis of clinical cases in 9 patients with esophageal anastomosis leak and 1 patient with postoperative focal necrosis of the esophageal wall from 2015 to 2016, using endoscopic technologies such as: implantation of coated self-expanding metal stents, endoscopic vacuum therapy and clipping are presented. In nine out of ten cases, thanks to the above endoscopic technologies, it was possible to solve the problem of pleurisy and mediastinitis in a short time, and also to improve the quality of life of patients.

Кеу words: stenting, anastomosis leak, esophageal cancer, perforation.