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Niti-S esophageal mega-stent : an emerging endoscopic tool with different applications in the management of surgical anastomotic leaks

datacite.subject.fosCiências Médicas
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorBrito, Mariana
dc.contributor.authorNunes, Gonçalo
dc.contributor.authorLuz, Carlos
dc.contributor.authorOliveira, Gabriel
dc.contributor.authorMarques, Pedro Pinto
dc.contributor.authorFonseca, Jorge
dc.date.accessioned2026-03-09T09:22:32Z
dc.date.available2026-03-09T09:22:32Z
dc.date.issued2023-09
dc.description.abstractIntroduction: Anastomotic leak (AL) is a dangerous complication in the early postoperative period after total gastrectomy or esophagectomy being associated with high mortality. Self-expandable metal stents (SEMS) play a significant role in AL management. Only one case report described the use of Mega-Stent in AL setting. The authors report a two-case series with different applications of a Niti-S esophageal Mega-Stent in AL management. Case Report: Case 1 is a 67-year-old male who underwent an esophagectomy due to a squamous cell carcinoma of the distal esophagus. The early postoperative period was complicated with AL and gastropleural fistula. Initially, an OTSC was deployed in the dehiscence but failed to resolve AL. The esophageal Mega-Stent was further placed in-between the esophagus and the bulbus. Post-stenting contrast studies confirmed no further AL.Case 2 is an 86-year-old woman who underwent total gastrectomy with roux-en-y esophagojejunostomy due to a gastric adenocarcinoma, complicated with AL. A partially covered metal stent (PCMS) was placed to cover the anastomosis. Computed tomography confirmed leakage persistence and a second PCMS was deployed, resolving the AL. Several weeks later, both PCMSs presented ingrowth from granulation tissue. An esophageal Mega-Stent was placed (stent-in-stent technique) and 2 weeks later, all stents were removed, with no AL recurrence. Discussion/Conclusion: SEMS placement for AL is a safe, well-established therapeutic technique. Limitations include stent migration and incomplete cover of large AL. Mega-Stent can be an emerging tool for endoscopic AL management.eng
dc.identifier.citationBrito, M., Nunes, G., Luz, C., Oliveira, G., Pinto Marques, P., & Fonseca, J. (2023). Niti-S Esophageal Mega-Stent: An Emerging Endoscopic Tool with Different Applications in the Management of Surgical Anastomotic Leaks. GE Portuguese journal of gastroenterology, 30(Suppl 1), 45–51. https://doi.org/10.1159/000524420
dc.identifier.doi10.1159/000524420
dc.identifier.issn2387-1954
dc.identifier.urihttp://hdl.handle.net/10400.26/62030
dc.language.isoeng
dc.peerreviewedyes
dc.publisherKarger
dc.relation.hasversionhttps://doi.org/10.1159/000524420
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectAnastomotic leak
dc.subjectEsophageal Mega-Stent
dc.subjectEsophageal stent
dc.subjectEndoscopy
dc.titleNiti-S esophageal mega-stent : an emerging endoscopic tool with different applications in the management of surgical anastomotic leakseng
dc.typecontribution to journal
dspace.entity.typePublication
oaire.citation.endPage51
oaire.citation.issueSupplement 1
oaire.citation.startPage45
oaire.citation.titleGE – Portuguese Journal of Gastroenterology
oaire.citation.volume30
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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