4.6 Article

Treatment of benign perforations and leaks of the esophagus: factors associated with success after stent placement

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SPRINGER
DOI: 10.1007/s00464-018-6096-1

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Self-expanding metal stent; Benign esophageal perforation; Anastomotic leakage

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Background Self-expanding metal stent (SEMS) is effective and safe for the treatment of benign esophageal perforations or leaks. The purpose of this study was to identify factors associated with clinical success after SEMS placement. Methods Patients who received SEMS placement for treatment of benign esophageal perforations or leaks were retrospectively identified. These patients were analyzed for factors associated with clinical success and complications. Results A total of 31 patients underwent stent insertion for benign esophageal perforations (n = 11) or anastomotic leaks (n = 20). Clinical success was achieved in twenty-three patients (74.2%) after initial stent insertion. In multivariate analysis, early stent insertion within 1 day was identified as a significant independent predictor of successful sealing (Odds ratio = 3.14, 95% CI 1.36-7.24; p = 0.013). The anastomotic leak group needed a longer stent dwelling time (>= 4 weeks) compared to the perforation group (75.0% vs. 27.3%, p = 0.022). Conclusions Clinical success was significantly associated with early stent insertion. The dwelling time of stent was shorter for benign perforations compared to anastomotic leaks.

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