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Updated: Nov 12, 2025

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Successful closure with covered self-expandable metal stent for severe anastomotic leakage in the cervical esophagus
Hideharu Okanobu1, Kozo Konishi2, Tomohiko Kohno3
1Department of Gastroenterology, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, 1-9-6, Sendamachi, Naka-ku, Hiroshima, 730-8619, Japan. okanobu@hiroshima-med.jrc.or.jp.
Abstract:
Anastomotic leakage is one of the major complications of esophageal surgery with a high mortality rate and significant morbidity. We describe a case of severe anastomotic leakage close to the hypopharynx after esophageal cancer resection. Despite the conservative management with external drainage, the severe leak did not improve. A fully covered self-expandable metal stent (SEMS) with short flares, which was designed for the cervical esophagus, was subsequently placed bridging the anastomosis to seal the fistula. The post-procedural course was uneventful, and the stent was endoscopically removed after three weeks without any complications. The patient was discharged home three weeks after the stent removal. Our results suggest that placement of fully covered SEMS with short flares may be a safe and effective treatment in this condition of patients.
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