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.