Rendezvous Stenting Technique for Anastomotic Leak After Total Gastrectomy: A Feasibility Study

TL;DR

This paper introduces a new stenting technique to manage anastomotic leaks after stomach removal surgery, showing it is safe and effective in most cases.

Contribution

The rendezvous stenting technique is proposed as a novel approach to control anastomotic leaks during reoperation.

Findings

Stenting controlled local contamination in 83.3% of patients.

One patient needed a repeat stent due to improper width.

The technique minimizes stent migration risk by combining drainage and fixation.

Abstract

Background and Objectives: Anastomotic leak following total gastrectomy and Roux-en-Y reconstruction remains a challenging and potentially morbid clinical scenario. Systemic support and resuscitation with simultaneous local sepsis control remain pillars of treatment. The therapeutic strategy may vary among different centers depending on the severity of clinical presentation, the degree of contamination and the hospital resources. The aim of this study is to introduce the rendezvous stenting technique, which combines washout of the abdominal cavity and endoscopic stenting under direct vision in selected patients who require reoperation. Materials and Methods: A retrospective descriptive analysis of severely ill patients suffering an anastomotic leak from an esophagojejunal anastomosis, who had been operated on in our department during the last five years was performed. Patient demographics, perioperative data and surgical outcomes were collected. Results: Since 2018, six anastomotic leak patients underwent stenting of anastomotic leak using the rendezvous technique during reoperation. Stenting was effective in controlling local contamination in five out of six patients (83.3%). One patient required repeat stent placement due to improper stent width. Conclusions: Anastomotic stenting using the rendezvous technique is a safe and feasible technique. Combining drainage of the abdominal cavity and stent fixation allows for control of the contaminated field as well as minimizing the risk of stent migration.

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