scholarly journals Endoscopic negative pressure therapy (ENPT) for duodenal leakage – novel repair technique using open-pore film (OFD) and polyurethane-foam drainages (OPD)

2019 ◽  
Vol 07 (11) ◽  
pp. E1424-E1431
Author(s):  
Gunnar Loske ◽  
Frank Rucktaeschel ◽  
Tobias Schorsch ◽  
Klaus Moenkemueller ◽  
Christian Theodor Mueller
Keyword(s):  
Polyurethane Foam ◽  
Negative Pressure ◽  
Gastric Resection ◽  
Complete Healing ◽  
Negative Pressure Therapy ◽  
Duodenal Ulcers ◽  
Pressure Therapy ◽  
Iatrogenic Perforation ◽  
Surgical Drain ◽  
Operative Closure

Abstract Background and study aims Endoscopic negative pressure therapy (ENPT) is used to close transmural defects in the rectum and esophagus. Very few reports have described ENPT to manage duodenal defects. This study was designed to demonstrate ENPT in a population of 11 patients with transmural duodenal leakages. Patients and methods The method of ENPT was adapted for duodenal use. Open-pore polyurethane-foam or a thin, open-pore double-layered film was wrapped around the distal end of a gastroduodenal tube. First, this open-pore element was placed on the inner wound in the duodenum with endoscopy. Second, continuous negative pressure of –125 mmHg was applied with an electronic pump. Drains were changed after 2 to 7 days. Results Eleven patients were treated with duodenal leaks. Eight defects occurred after operative closure of perforated duodenal ulcers, papillectomy or stricturoplasty, one anastomotic leakage after Billroth – 1 distal gastric resection, one iatrogenic perforation in endoscopic retrograde cholangiopancreatography, and one by a surgical drain. Median duration of therapy was 11 days (range 7 – 24 days). Complete healing of defects was achieved in all patients. Conclusion ENPT is an innovative endoscopic alternative for treatment of transmural duodenal defects.

Endoscopic negative pressure therapy with open-pore film drainage and open-pore polyurethane sponge drainage for iatrogenic perforation of the esophagus

Endoscopy ◽  
2020 ◽  
Vol 52 (05) ◽  
pp. 377-382 ◽  
Author(s):  
Dörte Wichmann ◽  
Dietmar Stüker ◽  
Ulrike Schempf ◽  
Christoph R. Werner ◽  
Volker Steger ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Therapy ◽  
First Line ◽  
Pressure Therapy ◽  
Iatrogenic Perforation ◽  
Film Drainage ◽  
First Line Therapy ◽  
Therapy Strategy ◽  
Polyurethane Sponge ◽  
Iatrogenic Esophageal Perforation

Abstract Background Management of iatrogenic esophageal perforation (IEP) is challenging. Endoscopic negative pressure therapy (ENPT) is an emerging and effective tool for the treatment of gastrointestinal and anastomotic leaks. We have used ENPT as first-line therapy for IEP since 2017. The aim of this study was to present our results with this strategy in patients with IEP. Methods Nine patients were treated with ENPT for IEP between August 2017 and August 2019. Their treatment characteristics, including duration of therapy, strategy used, and outcomes, were analyzed. Treatment included ENPT with open-pore film drainage (OFD) and open-pore polyurethane foam drainage (OPD). Results Early diagnosis (< 24 hours) of IEP occurred in four patients. After a mean (standard deviation) of 19.0 (13.5) days of ENPT, 6.4 (3.4) endoscopies, and 38.1 (40.3) days of hospitalization, endoscopic treatment was effective and successful in all of the patients. Additional video-assisted thoracic surgery (VATS) was done in four patients. Conclusions ENPT is an effective new method for the management of IEP. ENPT with OFD and OPD can be combined with minimally invasive operative methods for sepsis control in IEP.

scholarly journals Endoscopic negative-pressure therapy for duodenal leakage using new open-pore film and polyurethane foam drains with the pull-through technique

Endoscopy ◽  
2017 ◽  
Vol 49 (12) ◽  
pp. E300-E302 ◽  
Author(s):  
Gunnar Loske ◽  
Marc Liedke ◽  
Erik Schlöricke ◽  
Thomas Herrmann ◽  
Frank Rucktaeschel
Keyword(s):  
Polyurethane Foam ◽  
Negative Pressure ◽  
Negative Pressure Therapy ◽  
Pressure Therapy ◽  
Pull Through

Endoscopic negative pressure therapy with open-pore film drainage and open-pore polyurethane sponge drainage for iatrogenic perforation of the esophagus

Endoscopy ◽  
2020 ◽  
Vol 52 (05) ◽  
pp. C3-C3
Author(s):  
Dörte Wichmann ◽  
Dietmar Stüker ◽  
Ulrike Schempf ◽  
Christoph R. Werner ◽  
Volker Steger ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Therapy ◽  
Pressure Therapy ◽  
Iatrogenic Perforation ◽  
Film Drainage ◽  
Polyurethane Sponge

scholarly journals Endoscopic negative pressure therapy (ENPT) of a spontaneous oesophageal rupture (Boerhaave’s syndrome) with peritonitis – a new treatment option

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Gunnar Loske ◽  
Katrin Albers ◽  
Christian T. Mueller
Keyword(s):  
Negative Pressure ◽  
Treatment Cycle ◽  
Feeding Tube ◽  
Complete Healing ◽  
Boerhaave’S Syndrome ◽  
Negative Pressure Therapy ◽  
Pressure Therapy ◽  
Mortality And Morbidity ◽  
Boerhaave's Syndrome ◽  
Total Treatment

Abstract Objectives Boerhaave’s syndrome is a life-threatening disease with high mortality and morbidity. Endoscopic negative pressure therapy (ENPT) can be used to treat oesophageal perforations. Case presentation We report on a case of oesophageal rupture with peritonitis in a 35-year-old male patient. The start of treatment was 11 h after the perforation event. The treatment of the perforation defect was performed exclusively by intraluminal ENPT, the treatment of peritonitis was performed by laparotomy with abdominal lavage. For ENPT we used two different types of open-pore drains. The first treatment cycle of four days was performed with an open-pored polyurethane foam drainage (OPD), which was placed intraluminal to cover the perforation defect and to empty the stomach permanently. The second treatment cycle of nine days was performed with a thin nasogastric tube like double-lumen open-pored film drainage (OFD). For suction OPD and OFD were connected with an electronic vacuum pump (−125 mmHg). OFD enables active gastric emptying with simultaneous intestinal feeding via an integrated feeding tube. Intraluminal ENPT with a total treatment duration of 13 days was able to achieve the complete healing of the defect. Surgical treatment of the perforation defect was not necessary. The patient was discharged 20 days after initial treatment with a non-irritating abdominal wound and a closed perforation. Conclusions In suitable cases, endoscopic negative pressure therapy is a minimally invasive, organ-preserving procedure for the treatment of spontaneous oesophageal rupture.

Negative pressure therapy – How many dressing changes are enough?

2012 ◽  
Vol 60 (S 01) ◽  
Author(s):  
S Raab ◽  
T Weimann ◽  
W Sienel ◽  
L Lampl ◽  
M Beyer
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Therapy ◽  
Pressure Therapy

Four Cases of Lower Extremity Ulcers Treated with Negative Pressure Therapy

2015 ◽  
Vol 77 (5) ◽  
pp. 456-460
Author(s):  
Maiko SAKAMOTO-TOYA ◽  
Sho MIAKE ◽  
Satoko SHIBATA-KIKUCHI ◽  
Masutaka FURUE
Keyword(s):  
Lower Extremity ◽  
Negative Pressure ◽  
Negative Pressure Therapy ◽  
Pressure Therapy
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