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Surgical Innovation
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Natural Orifice Management of Anastomotic Leaks After Minimally Invasive Esophagogastrectomy

Ninh T. Nguyen, MD, FACS

Department of Surgery, University of California Irvine Medical Center, Orange, California, ninhn{at}uci.edu

Brian A. Mailey, MD

Department of Surgery, University of California Irvine Medical Center, Orange, California

Marcelo W. Hinojosa, MD

Department of Surgery, University of California Irvine Medical Center, Orange, California

Ken Chang, MD

Department of Medicine, University of California Irvine Medical Center, Orange, California

A leak after an esophagectomy can lead to significant morbidity and mortality. The treatment options for postoperative leaks include reoperation with pleural drainage and placement of T-tube drainage catheter to control the gastrointestinal leak or complete gastrointestinal diversion, depending on the extent of the leak and tissue viability of the gastric conduit. Both these options require an invasive reoperation. In selected cases, endoscopic deployment of a covered esophageal stent may be an effective minimally invasive option in the management of an esophageal leak. This report describes the indications and techniques for management of an esophageal leak using the natural orifice for drainage of a mediastinal abscess and deployment of an esophageal stent.

Key Words: esophageal leaks • endoscopic stent • esophagectomy

This version was published on December 1, 2008

Surgical Innovation, Vol. 15, No. 4, 249-252 (2008)
DOI: 10.1177/1553350608322925
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