Innovative Endoscopic Treatment of Dual Gastric Perforations Using Argon Plasma Coagulation and Hybrid Closure Techniques
Division
East Florida
Hospital
Kendall Regional Medical Center
Document Type
Case Report
Publication Date
5-8-2026
Keywords
Adenocarcinoma, Anastomotic, Argon, Gastroesophageal Junction, OVESCO
Disciplines
Internal Medicine | Medicine and Health Sciences | Surgical Procedures, Operative
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.
Publisher or Conference
Gastro Hep Advances
Recommended Citation
Oliva Y, Fadel A, Suarez J, Gascon JA, Hussain H. Innovative Endoscopic Treatment of Dual Gastric Perforations Using Argon Plasma Coagulation and Hybrid Closure Techniques. Gastro Hep Adv. 2026;5(8):100999. Published 2026 May 8. doi:10.1016/j.gastha.2026.100999