OUR EXPERIENCE IN ENDOPROSTHESIS OF INSUFFICIENCY ESOPATHIC SUTURE

Summary. Introduction. Esophageal anastomotic suture failure is one of the severe postoperative complications after esophagectomy. The pathogenesis of this complication is dominated by ongoing infection between the esophagus and the respiratory tract, mainly caused by fistulas of the esophagogastric anastomosis. Currently, interest in completing gastric resection with esophagojejunoanastomosis remains at the same level, mainly due to the high risk of anastomotic suture failure and the development of severe reflux esophagitis in the postoperative period. The aim of the work is to evaluate the results of using the endoprosthetics method in case of failure of esophageal sutures. Material and methods. The results of the examination and treatment of 84 patients who underwent surgical interventions on the basis of the State Institution «Institute of General and Emergency Surgery named after V.T. Zaitsev NAMSU» and the Kharkiv City Clinical Hospital of Emergency and Emergency Medical Care named after Prof. O. I. Meshchaninov with the development of complications in the postoperative period in the form of failure of esophageal anastomosis sutures are presented. All patients were divided into 2 clinical groups: the first (comparison group) 41 (48.8%) patients, the second (main group) 43 (51.2%) patients. Results of the study. In the main group of patients, 43 (51.2%) underwent minimally invasive surgical treatment using modern endoscopic technologies stenting. In the main group, patients were given self-expanding stents for endoprosthesis replacement, if indicated, using stents from M.I.Tech Co., Ltd. (Korea), esophageal coated HANAROSTEN with antireflux valve 14 and Boston Scientific Corp. (USA), esophageal coated Ultraflex 2. Conclusions. The method of choice for stent installation is X-ray endoscopic technique, which allows to adequately install the stent under visual control with the prevention of complications. Endoscopic stenting allows to effectively seal the failure zone, to provide optimal conditions for healing of the fistula, to avoid repeated surgery in case of a defect up to 1/3 of the anastomosis circumference, which significantly improves the results of treatment of this category of patients.