Successful Closure of a Gastropulmonary Fistula after Esophagectomy Using the Apollo Overstitch and Endoscopic Vacuum Therapy
Endoscopy(2018)
摘要
Gastropulmonary fistulas following transthoracic en bloc esophagectomy and intrathoracic gastric reconstruction (Ivor Lewis esophagectomy) are rare but life-threatening complications. Surgical management of these is difficult and associated with significant instances of morbidity and mortality [1]. One possible treatment for leaks after upper gastrointestinal surgery is endoluminal vacuum therapy (EVT) [2]. A newer treatment option is the endoscopic suturing system Apollo Overstitch [3] [4] [5]. The Overstitch is a single-use device that is placed on top of a double-channel therapeutic endoscope, which facilitates full-thickness surgical suturing in single or running technique. To our knowledge, the case presented below constitutes the first successful clinical application of a combination of Overstitch and EVT to close a gastropulmonary fistula after Ivor Lewis esophagectomy.
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