Here we report the case of a 61 year-old-woman who underwent total gastrectomy for cardial adenocarcinoma. Few days later, she developed anastomotic dehiscence, endoscopically treated with stent-in-stent technique. Implementation of a partially covered self-expandable-metal-stent (SEMS) for 4 weeks followed by insertion of a fully covered SEMS for 2 weeks to induce a pressure necrosis to facilitate removal of the partially covered SEMS.
The fully covered SEMS was easily removed. However, due to severe tissue hyperplasia, the removal of partially covered SEMS failed. Therefore, tissue ablation was performed using APC 3 (forcedAPC, effect 6.0) with an FiAPC® probe. The procedure was effective and the partially covered SEMS was removed.
No adverse events (i.e. perforation or bleeding) occurred, and a complete healing of the dehiscence was obtained.