Early endoscopic management of anastomotic leakage of esophageal atresia

Ilhan H., Tokar B.

MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES, vol.11, no.5-6, pp.321-324, 2002 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 11 Issue: 5-6
  • Publication Date: 2002
  • Doi Number: 10.1080/13645706.2003.11873733
  • Journal Name: MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.321-324
  • Keywords: esophagus, atresia, endoscopy, anastomotic leakage, fibrin glue, FIBRIN SEALANT, SURGERY
  • Eskisehir Osmangazi University Affiliated: Yes

Abstract

Anastomotic leaks (AL) of esophageal atresia (EA) close spontaneously with tube drainage and nutritional support, but this conservative management carries some risk factors. The present study describes an alternative endoscopic approach in evaluation and management. The endoscopic procedure, including esophagoscopy, catheterization of leakage point, and application of fibrin glue (FG) has been evaluated. It was applied seven times to four patients. The diagnostic criteria, the technique and the results are discussed. It has been determined that early endoscopic demonstration of AL in EA and application of FG prevent the possible complications of the conservative management, such as mediastinitis and lung collapse with pneumothorax due to ineffective chest drain, and side effects of parenteral nutrition and antibiotics. If a quickly solidified FG in a proper amount (<0,5 ml) is used in an early phase with a correct positioning of the AL by radiological or endoscopic examination, a satisfactory result can be obtained.