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Updated: Jun 16, 2026
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Innovative Endoscopic Treatment of Dual Gastric Perforations Using Argon Plasma Coagulation and Hybrid Closure
Yanie Oliva1, Aya Fadel2, Jorge Suarez1
1Department of Internal Medicine, HCA Florida Kendall Hospital, Miami, Florida.
Abstract:
Anastomotic leaks and conduit perforations are serious complications following Ivor Lewis esophagectomy. A 65-year-old man with tobacco use, obesity, obstructive sleep apnea, hypertension, and gastroesophageal junction adenocarcinoma underwent Ivor Lewis esophagectomy complicated by an anastomotic leak. Endoscopy confirmed dehiscence, successfully treated with a 20 mm AXIOS stent. A second full-thickness perforation from a chest tube traversing the gastric conduit staple line was also identified. Multiple endoscopic attempts, including argon plasma coagulation, OVESCO clipping, and OverStitch suturing, failed due to poor tissue apposition. A novel approach using Surgicel packing with fibrin sealant and Dermabond achieved closure. Chest tubes were removed, and the patient recovered fully, highlighting an effective salvage strategy in complex postoperative complications.
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