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Revista colombiana de Gastroenterología
Print version ISSN 0120-9957On-line version ISSN 2500-7440
Abstract
VARGAS,, Rómulo; COSTA,, Valeria and OVALLE., Alan Felipe. Self-expanding metal stents for endoscopic management of esophageal and gastric fistulas. Rev. colomb. Gastroenterol. [online]. 2021, vol.36, n.3, pp.313-320. Epub Dec 10, 2021. ISSN 0120-9957. https://doi.org/10.22516/25007440.646.
Objective:
To demonstrate the efficacy and safety of self-expanding metal stents for endoscopic management of esophageal fistulas.
Materials and methods:
Retrospective case series between 2007 and 2017. A total of 11 patients were treated with self-expanding metal stents for esophageal fistula management, after being diagnosed based on symptoms, upper endoscopy, and/or radiological studies in the gastroenterology unit of the Hospital Universitario San Ignacio (HUSI) in Bogotá D.C, Colombia.
Results:
The most common initial symptom was dyspnea in 27.3% of cases, followed by cough in 18.2%. The most frequent finding during follow-up was pleural effusion in 36.4% of the cases, of which 45.5% received a diagnosis of fistula through esophagogram. The most reported lesion was esophagoenteric anastomotic leak with 45.5%, followed by esophagopleural injury with 36.4%; these patients were those who received self-expanding metal stent management. Technical success was achieved in 100% of the cases, and the defect was resolved in in 72.7% of them. The only complication reported was stent migration in 27.3%, requiring 3 changes in 1 patient. The average hospital stay was 41.5 days.
Conclusions:
Endoscopic management of esophagogastric fistulas with self-expanding metal stents is effective and safe, with a low complication rate.
Keywords : Esophageal fistulas; Self-expanding metal stent; Anastomosis; Complications; Esophageal surgery.