504 THE USE OF ENDOSCOPIC VACUUM THERAPY (EVT) AS COMPARED TO ENDOSCOPIC STENTING (ES) FOR LEAKAGES AFTER FOREGUT SURGERY

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
S Chan ◽  
H Yip ◽  
A Teoh ◽  
P Chiu ◽  
E Ng
Keyword(s):  
Success Rate ◽  
Retrospective Cohort ◽  
Stent Migration ◽  
The Other ◽  
Vacuum Therapy ◽  
Endoscopic Stenting ◽  
Anastomotic Leaks ◽  
Foregut Surgery ◽  
Endoscopic Vacuum Therapy ◽  
Type Of Surgery

Abstract   Anastomotic leakage after foregut surgeries are often difficult to manage. The conventional way of endoscopic treatment is ES. However, it carries a risk of stent migration and erosion. EVT is a novel way of treating these leaks. Methods This was a retrospective cohort study including all patients with anastomotic leak after foregut surgery and were treated with ES or EVT between July 2008 and July 2019. Patients’ demographics, type of surgery, size of anastomotic defect, success rate, complications, number of procedures were recorded and compared. Results There were 17 patients treated with ES and 7 patients treated with EVT. The success rate of both therapies are similar. (11/17(64.7%) in the ES group vs 5/7(71.4%) in the EVT group; p = 0.751). However, there was a trend to less complications in the EVT group (9/17 (52.9%) in ES group vs. 1/7(14.2%) in EVT group; p = 0.135). On the other hand, the EVT group has a trend to requiring more endoscopic procedures (median (range) 3 (7) procedures in the ES group vs 6(11) in the EVT group; p 0.435). Conclusion The use of EVT is feasible and safe in treating anastomotic leaks after foregut surgeries. Although more procedures are required, it achieved similar success rate while having a trend to less complications.

scholarly journals 253 THE USE OF ENDOSCOPIC VACUUM THERAPY (EVT) OR COMBINATION THERAPY WITH ENDOSCOPIC STENTING AS COMPARED TO ENDOSCOPIC STENTING (ES) ALONE FOR LEAKAGES AFTER FOREGUT SURGERY

2020 ◽  
Vol 91 (6) ◽  
pp. AB28-AB29
Author(s):  
Shannon M. Chan ◽  
Stefan Seewald ◽  
Ho wai Ip ◽  
Tom Chi Man Chow ◽  
Stefan Groth ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Vacuum Therapy ◽  
Endoscopic Stenting ◽  
Foregut Surgery ◽  
Endoscopic Vacuum Therapy

VACStent: a new option for endoscopic vacuum therapy in patients with esophageal anastomotic leaks after upper gastrointestinal surgery

Endoscopy ◽  
2019 ◽  
Vol 52 (05) ◽  
pp. E166-E167 ◽  
Author(s):  
Seung-Hun Chon ◽  
Isabel Bartella ◽  
Martin Bürger ◽  
Isabel Rieck ◽  
Tobias Goeser ◽  
...  
Keyword(s):  
Gastrointestinal Surgery ◽  
Vacuum Therapy ◽  
Anastomotic Leaks ◽  
Endoscopic Vacuum Therapy ◽  
Upper Gastrointestinal

scholarly journals First UK experience of endoscopic vacuum therapy for the management of oesophageal perforations and postoperative leaks

2019 ◽  
Vol 10 (2) ◽  
pp. 200-203 ◽  
Author(s):  
Alaa Alakkari ◽  
Ruchit Sood ◽  
Simon M Everett ◽  
Bjorn J Rembacken ◽  
Jeremy Hayden ◽  
...  
Keyword(s):  
Jejunal Interposition ◽  
The Other ◽  
Morbidity And Mortality ◽  
Oesophageal Perforation ◽  
Vacuum Therapy ◽  
High Morbidity ◽  
Novel Treatment ◽  
Endoscopic Vacuum Therapy ◽  
British Experience ◽  
The Uk

Oesophageal perforations and anastomotic leaks are associated with high morbidity and mortality. Endoscopic vacuum therapy (EVT) is a promising novel treatment that promotes healing and avoids sepsis. There are no data reporting its use in the UK. We report the first British experience of EVT in two elderly frail patients. Two patients were treated in our institution with EVT using Eso-SPONGE®. One patient had spontaneous oesophageal perforation and the other had anastomotic leakage post-Merendino oesophageal reconstruction (oesophagogastric continuity with jejunal interposition anastomosis). Both patients were over 65 years of age. One patient had 13 endoscopic Eso-SPONGE® exchanges over 8 weeks, while the other one had 6 exchanges over 4 weeks. Complete resolution of oesophageal leakage was achieved in both cases. EVT should be considered in the management of patients with oesophageal perforations and postoperative leaks. This novel therapeutic intervention has the potential to significantly reduce morbidity and mortality in these patients.

Long-term efficacy of endoscopic vacuum therapy for the treatment of colorectal anastomotic leaks

2015 ◽  
Vol 47 (4) ◽  
pp. 342-345 ◽  
Author(s):  
Alberto Arezzo ◽  
Mauro Verra ◽  
Roberto Passera ◽  
Alberto Bullano ◽  
Lisa Rapetti ◽  
...  
Keyword(s):  
Vacuum Therapy ◽  
Anastomotic Leaks ◽  
Term Efficacy ◽  
Endoscopic Vacuum Therapy

scholarly journals A Novel Hybrid Stent with Endoscopic Vacuum Therapy for Treating Leaks of the Upper Gastrointestinal Tract

2020 ◽  
pp. 1-7
Author(s):  
Seung-Hun Chon ◽  
Ulrich Töx ◽  
Florian Lorenz ◽  
Isabel Rieck ◽  
Britta Janina Wagner ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Success Rate ◽  
Upper Gastrointestinal Tract ◽  
Metal Stents ◽  
Vacuum Therapy ◽  
Line Treatment ◽  
Promising Alternative ◽  
Number Of Patients ◽  
Endoscopic Vacuum Therapy ◽  
Upper Gastrointestinal

<b><i>Introduction:</i></b> Self-expanding metal stents (SEMS) are an established option for treating leaks in the upper gastrointestinal tract, and endoscopic vacuum therapy (EVT) has become a promising alternative. A novel approach is the use of an esophageal hybrid SEMS (VACStent®), which can maintain esophageal passage during EVT. We present the first study demonstrating successful use of the VACStent® for treating leaks of the upper gastrointestinal tract. <b><i>Method:</i></b> We performed a retrospective, single-center study of all patients who underwent endoscopic stenting with the VACStent® of leaks in the upper gastrointestinal tract. <b><i>Results:</i></b> Indications for treatment with the VACStent® were: iatrogenic esophageal perforation (<i>n</i> = 1), spontaneous perforation (<i>n</i> = 2), esophageal fistula (<i>n</i> = 2), and anastomotic leak after upper gastrointestinal surgery (<i>n</i> = 5). Successful application of the VACStent® was achieved in all patients (<i>n</i> = 10; 100%) with a total of 15 interventions. VACStent® therapy was used as a first-line treatment in 5 patient (success rate 80%; 4 out 5 patients) and as a second-line treatment after failed previous endoscopic therapy in 5 patients (success rate 60%; 3 out of 5 patients). Overall, VACStent® treatment was successful in 70% of the patients (7 out of 10). No severe VACStent® treatment-related adverse events occurred. <b><i>Conclusion:</i></b> The initial experience has been that the technical application of the VACStent® is safe and technically feasible. However, due to the small number of patients this study could not show the clear advantages of this novel hybrid stent. More studies are necessary to show significant advantages.

scholarly journals Endoscopic vacuum therapy versus stent treatment of esophageal anastomotic leaks (ESOLEAK): study protocol for a prospective randomized phase 2 trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Michael Tachezy ◽  
Seung-Hun Chon ◽  
Isabel Rieck ◽  
Marcus Kantowski ◽  
Hildegard Christ ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anastomotic Leak ◽  
Vacuum Therapy ◽  
Phase 2 ◽  
Anastomotic Leaks ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy ◽  
Endoscopic Vacuum Therapy ◽  
Eortc Qlq

Abstract Background Intrathoracic anastomotic leaks represent a major complication after Ivor Lewis esophagectomy. There are two promising endoscopic treatment strategies in the case of leaks: the placement of self-expanding metal stents (SEMS) or endoscopic vacuum therapy (EVT). Up to date, there is no prospective data concerning the optimal endoscopic treatment strategy. This is a protocol description for the ESOLEAK trial, which is a first small phase 2 randomized trial evaluating the quality of life after treatment of anastomotic leaks by either SEMS placement or EVT. Methods This phase 2 randomized trial will be conducted at two German tertiary medical centers and include a total of 40 patients within 2 years. Adult patients with histologically confirmed esophageal cancer, who have undergone Ivor Lewis esophagectomy and show an esophagogastric anastomotic leak on endoscopy or present with typical clinical signs linked to an anastomotic leak, will be included in our study taking into consideration the exclusion criteria. After endoscopic verification of the anastomotic leak, patients will be randomized in a 1:1 ratio into two treatment groups. The intervention group will receive EVT whereas the control group will be treated with SEMS. The primary endpoint of this study is the subjective quality of life assessed by the patient using a systematic and validated questionnaire (EORTC QLQ C30, EORTC QLQ-OES18 questionnaire). Important secondary endpoints are healing rate, period of hospitalization, treatment-related complications, and overall mortality. Discussion The latest meta-analysis comparing implantation of SEMS with EVT in the treatment of esophageal anastomotic leaks suggested a higher success rate for EVT. The ESOLEAK trial is the first study comparing both treatments in a prospective manner. The aim of the trial is to find suitable endpoints for the treatment of anastomotic leaks as well as to enable an adequate sample size calculation and evaluate the feasibility of future interventional trials. Due to the exploratory design of this pilot study, the sample size is too small to answer the question, whether EVT or SEMS implantation represents the superior treatment strategy. Trial registration ClinicalTrials.gov NCT03962244. Registered on May 23, 2019. DRKS-ID DRKS00007941

Endoscopic vacuum therapy versus endoscopic stenting for upper gastrointestinal transmural defects: Systematic review and meta‐analysis

2020 ◽  
Author(s):  
Epifanio Silvino do Monte Junior ◽  
Diogo Turiani Hourneaux de Moura ◽  
Igor Braga Ribeiro ◽  
Kelly Elizabeth Hathorn ◽  
Galileu Ferreira Ayala Farias ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Vacuum Therapy ◽  
Endoscopic Stenting ◽  
Endoscopic Vacuum Therapy ◽  
Upper Gastrointestinal

ENDOSCOPIC VACUUM THERAPY FOR PROXIMAL ANASTOMOTIC LEAKS

2018 ◽  
Author(s):  
K Shishin ◽  
I Nedoluzhko ◽  
N Kurushkina ◽  
L Shumkina ◽  
A Pyatakova
Keyword(s):  
Vacuum Therapy ◽  
Anastomotic Leaks ◽  
Endoscopic Vacuum Therapy

Efficacy of endoscopic vacuum therapy for the treatment of colorectal anastomotic leaks

2019 ◽  
Vol 21 (2) ◽  
pp. 104-108
Author(s):  
Mauro Verra ◽  
Edoardo Forcignanò ◽  
Giacomo Lo Secco ◽  
Alberto Arezzo
Keyword(s):  
Vacuum Therapy ◽  
Anastomotic Leaks ◽  
Endoscopic Vacuum Therapy
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