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

Area of Science:

• Gastroenterology
• Surgical Innovation
• Medical Device Technology

Background:

• Anastomotic leak post-total gastrectomy with Roux-en-Y reconstruction presents significant morbidity.
• Current treatment relies on systemic support, resuscitation, and local sepsis control, with strategies varying by clinical severity and resources.
• Reoperation for anastomotic leaks is complex and challenging.

Purpose of the Study:

• To introduce and evaluate the rendezvous stenting technique for managing anastomotic leaks.
• To assess the safety and feasibility of combining abdominal washout with endoscopic stenting during reoperation.
• To provide a novel therapeutic option for selected patients with severe anastomotic leaks.

Main Methods:

• Retrospective analysis of severely ill patients with esophagojejunal anastomotic leaks requiring reoperation.
• Application of the rendezvous stenting technique, involving abdominal cavity washout and direct-vision endoscopic stenting.
• Collection of patient demographics, perioperative data, and surgical outcomes.

Main Results:

• Six patients with anastomotic leaks underwent rendezvous stenting since 2018.
• The technique successfully controlled local contamination in 83.3% (5 out of 6) of patients.
• One patient required repeat stenting due to inadequate stent width, highlighting the importance of proper stent selection.

Conclusions:

• Rendezvous stenting is a safe and feasible technique for managing anastomotic leaks.
• The combined approach of abdominal drainage and stent fixation effectively controls contamination and minimizes stent migration.
• This technique offers a promising solution for selected patients requiring reoperation for anastomotic leaks.