International multicenter expert survey on endoscopic treatment of upper gastrointestinal anastomotic leaks

Background and study aims: A variety of endoscopic techniques are currently available for treatment of upper gastrointestinal (UGI) anastomotic leaks; however, no definite consensus exists on the most appropriate therapeutic approach. Our aim was to explore current management of UGI anastomotic leak...

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Autores: Rodrigues-Pinto, Eduardo, Repici, Alessandro, Donatelli, Gianfranco, Macedo, Guilherme, Deviere, Jacques, van Hooft, Jeanin E., Campos, Josemberg M., Neto, Manoel Galvao, Silva, Marco, Eisendrath, Pierre, Kumbhari, Vivek, Khashab, Mouen A., Gornals Soler, Joan B.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/168858
Acceso en línea:https://hdl.handle.net/2445/168858
Access Level:acceso abierto
Palabra clave:Cirurgia endoscòpica
Malalties del tracte gastrointestinal
Endoscopic surgery
Gastrointestinal system diseases
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spelling International multicenter expert survey on endoscopic treatment of upper gastrointestinal anastomotic leaksRodrigues-Pinto, EduardoRepici, AlessandroDonatelli, GianfrancoMacedo, GuilhermeDeviere, Jacquesvan Hooft, Jeanin E.Campos, Josemberg M.Neto, Manoel GalvaoSilva, MarcoEisendrath, PierreKumbhari, VivekKhashab, Mouen A.Gornals Soler, Joan B.Cirurgia endoscòpicaMalalties del tracte gastrointestinalEndoscopic surgeryGastrointestinal system diseasesBackground and study aims: A variety of endoscopic techniques are currently available for treatment of upper gastrointestinal (UGI) anastomotic leaks; however, no definite consensus exists on the most appropriate therapeutic approach. Our aim was to explore current management of UGI anastomotic leaks. Methods: A survey questionnaire was distributed among international expert therapeutic endoscopists regarding management of UGI anastomotic leaks. Results: A total of 44 % of 163 surveys were returned; 69 % were from gastroenterologists and 56 % had > 10 years of experience. A third of respondents treat between 10 and 19 patients annually. Fifty-six percent use fully-covered self-expandable metal stents as their usual first option; 80% use techniques to minimize migration; 4 weeks was the most common reported stent dwell time. Sixty percent perform epithelial ablation prior to over-the-scope-clip placement or suturing. Regarding endoscopic vacuum therapy (EVT), 56 % perform balloon dilation and intracavitary EVT in patients with large cavities but small leak defects. Regarding endoscopic septotomy, 56 % consider a minimal interval of 4 weeks from surgery and 90 % consider the need to perform further sessions. Regarding endoscopic internal drainage (EID), placement of two stents and shorter stents is preferred. Persistent inflammation with clinical sepsis was the definition most commonly reported for endoscopic failure. EVT/stent placement and EVT/EID were the therapeutic options most often chosen in patients with previous oncologic surgery and previous bariatric surgery, respectively. Conclusions: There is a wide variation in the management of patients with UGI anastomotic leaks. Future prospective studies are needed to move from an expert- to evidence- and personalization-based care.Georg Thieme Verlag Kg2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/168858Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1055/a-1005-6632Endoscopy International Open, 2019, vol. 7, num. 12, p. E1671-E1682https://doi.org/10.1055/a-1005-6632cc by-nc-nd (c) Georg Thieme Verlag KG, 2019http://creativecommons.org/licenses/by-nc-nd/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1688582026-05-27T06:46:51Z
dc.title.none.fl_str_mv International multicenter expert survey on endoscopic treatment of upper gastrointestinal anastomotic leaks
title International multicenter expert survey on endoscopic treatment of upper gastrointestinal anastomotic leaks
spellingShingle International multicenter expert survey on endoscopic treatment of upper gastrointestinal anastomotic leaks
Rodrigues-Pinto, Eduardo
Cirurgia endoscòpica
Malalties del tracte gastrointestinal
Endoscopic surgery
Gastrointestinal system diseases
title_short International multicenter expert survey on endoscopic treatment of upper gastrointestinal anastomotic leaks
title_full International multicenter expert survey on endoscopic treatment of upper gastrointestinal anastomotic leaks
title_fullStr International multicenter expert survey on endoscopic treatment of upper gastrointestinal anastomotic leaks
title_full_unstemmed International multicenter expert survey on endoscopic treatment of upper gastrointestinal anastomotic leaks
title_sort International multicenter expert survey on endoscopic treatment of upper gastrointestinal anastomotic leaks
dc.creator.none.fl_str_mv Rodrigues-Pinto, Eduardo
Repici, Alessandro
Donatelli, Gianfranco
Macedo, Guilherme
Deviere, Jacques
van Hooft, Jeanin E.
Campos, Josemberg M.
Neto, Manoel Galvao
Silva, Marco
Eisendrath, Pierre
Kumbhari, Vivek
Khashab, Mouen A.
Gornals Soler, Joan B.
author Rodrigues-Pinto, Eduardo
author_facet Rodrigues-Pinto, Eduardo
Repici, Alessandro
Donatelli, Gianfranco
Macedo, Guilherme
Deviere, Jacques
van Hooft, Jeanin E.
Campos, Josemberg M.
Neto, Manoel Galvao
Silva, Marco
Eisendrath, Pierre
Kumbhari, Vivek
Khashab, Mouen A.
Gornals Soler, Joan B.
author_role author
author2 Repici, Alessandro
Donatelli, Gianfranco
Macedo, Guilherme
Deviere, Jacques
van Hooft, Jeanin E.
Campos, Josemberg M.
Neto, Manoel Galvao
Silva, Marco
Eisendrath, Pierre
Kumbhari, Vivek
Khashab, Mouen A.
Gornals Soler, Joan B.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Cirurgia endoscòpica
Malalties del tracte gastrointestinal
Endoscopic surgery
Gastrointestinal system diseases
topic Cirurgia endoscòpica
Malalties del tracte gastrointestinal
Endoscopic surgery
Gastrointestinal system diseases
description Background and study aims: A variety of endoscopic techniques are currently available for treatment of upper gastrointestinal (UGI) anastomotic leaks; however, no definite consensus exists on the most appropriate therapeutic approach. Our aim was to explore current management of UGI anastomotic leaks. Methods: A survey questionnaire was distributed among international expert therapeutic endoscopists regarding management of UGI anastomotic leaks. Results: A total of 44 % of 163 surveys were returned; 69 % were from gastroenterologists and 56 % had > 10 years of experience. A third of respondents treat between 10 and 19 patients annually. Fifty-six percent use fully-covered self-expandable metal stents as their usual first option; 80% use techniques to minimize migration; 4 weeks was the most common reported stent dwell time. Sixty percent perform epithelial ablation prior to over-the-scope-clip placement or suturing. Regarding endoscopic vacuum therapy (EVT), 56 % perform balloon dilation and intracavitary EVT in patients with large cavities but small leak defects. Regarding endoscopic septotomy, 56 % consider a minimal interval of 4 weeks from surgery and 90 % consider the need to perform further sessions. Regarding endoscopic internal drainage (EID), placement of two stents and shorter stents is preferred. Persistent inflammation with clinical sepsis was the definition most commonly reported for endoscopic failure. EVT/stent placement and EVT/EID were the therapeutic options most often chosen in patients with previous oncologic surgery and previous bariatric surgery, respectively. Conclusions: There is a wide variation in the management of patients with UGI anastomotic leaks. Future prospective studies are needed to move from an expert- to evidence- and personalization-based care.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/168858
url https://hdl.handle.net/2445/168858
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1055/a-1005-6632
Endoscopy International Open, 2019, vol. 7, num. 12, p. E1671-E1682
https://doi.org/10.1055/a-1005-6632
dc.rights.none.fl_str_mv cc by-nc-nd (c) Georg Thieme Verlag KG, 2019
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc-nd (c) Georg Thieme Verlag KG, 2019
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Georg Thieme Verlag Kg
publisher.none.fl_str_mv Georg Thieme Verlag Kg
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300719

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