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Endoscopic techniques in the management of esophagojejunal dehiscence after total gastrectomy.

ABSTRACT:

SUBMITTER: Thanavachirasin K

PROVIDER: S-EPMC5990957 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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Endoscopic techniques in the management of esophagojejunal dehiscence after total gastrectomy.

Thanavachirasin Komdej K Marcotte Eric E Prathanvanich Pornthep P Chand Bipan B

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 20170204 5

PMID: 29905287

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Project description:Background and objectiveFew studies on endoscopic management of primary obstructive megaureter (POM) in adult patients have been reported. Our objective was to describe our technique and long-term outcomes for endoscopic management of adult POM.MethodsWe included 76 adult POM patients undergoing endoscopic management between September 2015 and January 2024. Under endoscopic control, the stricture was dilated to 24-30 Fr while maintaining a balloon pressure of 25-35 atm for 3 min. An additional incision of the stenotic ring using either an electrode or holmium laser was performed in 39 patients. Data for patient characteristics, intraoperative variables, surgical complications, and follow-up results were analyzed. A descriptive statistical analysis was performed. Surgical success was defined as no tubes or stents in the body, stable or improved symptoms and renal function, and the absence of reflux or obstruction during the follow-up period.Key findings and limitationsAll procedures were completed without conversion to open or laparoscopic surgery. The median operative time was 45 min (range 16-165) with median estimated blood loss of 2 ml (range 0-150). The median postoperative hospital stay was 3 d (range 1-15). No intraoperative complication occurred. At median postoperative follow-up of 42 mo (range 3-100) the overall success rate was 92.1%. Restenosis of the vesicoureteral junction (Clavien-Dindo grade III) occurred in five patients (6.6%), and high-grade vesicoureteral reflux occurred in one patient (1.3%), all of whom required secondary reconstruction surgery.Conclusions and clinical implicationsThe results indicate that our endoscopic management for adult POM is safe and effective, with favorable long-term outcomes. This approach could potentially serve as a first-line treatment option for adult POM.Patient summaryPrimary obstructive megaureter (POM) occurs when the flow of urine is blocked because of a narrow segment in the tube between the kidney and bladder (ureter), which causes widening of the ureter further up. For our minimally invasive technique, a telescope is inserted through the urethra and bladder to reach the ureter for surgical treatment. Our results show that this is a safe procedure for POM in adults.

Dataset Information

Endoscopic techniques in the management of esophagojejunal dehiscence after total gastrectomy.

Publications

Endoscopic techniques in the management of esophagojejunal dehiscence after total gastrectomy.

Similar Datasets

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