Covid-19 as a Barrier for Delaying Therapeutic Endoscopy After Radical Treatment of Upper Gastrointestinal Cancer. Analysis of Clinical Cases

Aims We decided to present several patient’s cases that had several therapeutic endoscopies and follow ups after radical treatment of upper gastrointestinal cancer, as well as point out the problems associated with treatment delay due to COVID-19 pandemic.

Methods The patients we included had some therapeutic endoscopic procedures delayed due to pandemic.

Results First patient - 56 years old, had oesophagus resection in June 2018, followed by gastroplasty and adjuvant chemotherapy.

In August 2018 had a follow up where anastomose stricture was observed. Afterwards patient received 8 dilatation procedures during year’s time and in October 2019 self-expandable metallic stent (SEMS) was inserted to reduce the frequency of dilatation procedures. On time evacuation 6 weeks after the insertion and a follow up in January 2020. Unfortunately, the stricture has formed repeatedly and patient has to continue dilatation procedures every month.

Patient agrees for another SEMS just before the pandemic in March, afterwards several moths delay due to COVID-19 associated procedures, so next follow up only in August 2020 where we see an embedded stent. Evacuation was unsuccessful and patient had to have an operation during which the oesophagus was replaced with small intestine. A week later after surgery patient’s state worsens because of necrosis of autotransplant followed by patient’s death.

Our second patient - 69 years old, had oesophagus reresection in January 2020. Postoperative period with complications as the patient has a leakage of newly formed anastomosis and we decided to insert SEMS for further support.

Afterwards 4 months delay due to the pandemic, as patient comes for follow up only in July 2020. In this case we were able to remove the embedded stent with stent-in-stent technique and instruct the patient to continue follow up every month for dilatation procedures.

Conclusions Delayed treatment due to COVID-19 makes management more complex.

Citation: Basina O, Lapina A, Sivins A etal. eP284 COVID-19 AS A BARRIER FOR DELAYING THERAPEUTIC ENDOSCOPY AFTER RADICAL TREATMENT OF UPPER GASTROINTESTINAL CANCER. ANALYSIS OF CLINICAL CASES. Endoscopy 2021; 53: S191.

Publication History

Article published online:
19 March 2021