The success of Eso-SPONGE® therapy in the treatment of anastomotic dehiscence after Ivor-Lewis subtotal esophagectomy: A case report

Lorenzo Federico Zini Radaelli; Beatrice Aramini; Angelo Ciarrocchi; Stefano Sanna; Desideria Argnani; Franco Stella

doi:10.1016/j.ijscr.2021.106525

The success of Eso-SPONGE® therapy in the treatment of anastomotic dehiscence after Ivor-Lewis subtotal esophagectomy: A case report

Int J Surg Case Rep. 2021 Nov:88:106525. doi: 10.1016/j.ijscr.2021.106525. Epub 2021 Oct 18.

Authors

Lorenzo Federico Zini Radaelli¹, Beatrice Aramini², Angelo Ciarrocchi³, Stefano Sanna⁴, Desideria Argnani⁵, Franco Stella⁶

Affiliations

¹ Thoracic Surgery Unit, Dipartment of Diagnostic and Specialty Medicine - DIMES of the Alma Mater Studiorum, University of Bologna, G.B. Morgagni - L. Pierantoni Hospital, 34 Carlo Forlanini Street, 47121 Forlì, Italy. Electronic address: lorenzo.radaelli2@studio.unibo.it.
² Thoracic Surgery Unit, Dipartment of Diagnostic and Specialty Medicine - DIMES of the Alma Mater Studiorum, University of Bologna, G.B. Morgagni - L. Pierantoni Hospital, 34 Carlo Forlanini Street, 47121 Forlì, Italy. Electronic address: beatrice.aramini@auslromagna.it.
³ Thoracic Surgery Unit, Dipartment of Diagnostic and Specialty Medicine - DIMES of the Alma Mater Studiorum, University of Bologna, G.B. Morgagni - L. Pierantoni Hospital, 34 Carlo Forlanini Street, 47121 Forlì, Italy. Electronic address: angelo.ciarrocchi@studio.unibo.it.
⁴ Thoracic Surgery Unit, Dipartment of Diagnostic and Specialty Medicine - DIMES of the Alma Mater Studiorum, University of Bologna, G.B. Morgagni - L. Pierantoni Hospital, 34 Carlo Forlanini Street, 47121 Forlì, Italy. Electronic address: stefano.sanna@auslromagna.it.
⁵ Thoracic Surgery Unit, Dipartment of Diagnostic and Specialty Medicine - DIMES of the Alma Mater Studiorum, University of Bologna, G.B. Morgagni - L. Pierantoni Hospital, 34 Carlo Forlanini Street, 47121 Forlì, Italy. Electronic address: desideria.argnani@auslromagna.it.
⁶ Thoracic Surgery Unit, Dipartment of Diagnostic and Specialty Medicine - DIMES of the Alma Mater Studiorum, University of Bologna, G.B. Morgagni - L. Pierantoni Hospital, 34 Carlo Forlanini Street, 47121 Forlì, Italy. Electronic address: franco.stella@unibo.it.

Abstract

Introduction: Eso-SPONGE® has proved to be an excellent method for the treatment of persistent dehiscence of the intrathoracic esophagogastric anastomosis during the operation of subtotal esophagectomy sec. Ivor Lewis.

Clinical case presentation: The case presented is of a 72-year-old patient with esophageal adenocarcinoma (ADK) who underwent sub-total esophagectomy and esophagoplasty sec. Ivor Lewis complicated by an esophageal leak. The Eso-SPONGE® therapy has been successful halving the index of inflammation after the first two sessions and generation of a neowall after seven sessions.

Discussion: Eso-SPONGE® therapy has proven to be a valuable resource as a treatment for esophageal anastomotic dehiscences because it is easily repeatable in suburban centers, provided that they have a digestive endoscopy specialized in the positioning process.

Conclusions: Eso-SPONGE® is a minimally invasive method that delivers excellent results in the treatment of fragile patients, such as those who have post-esophageal anastomotic dehiscence.

Keywords: Eso-SPONGE®; Esophageal anastomosis; Esophageal dehiscence case report; Esophagectomy; Ivor-Lewis's technique; Surgery of esophagus.