Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience

Aim. To study the efficacy of E-VAC therapy for patients with anastomotic leakage after esophagectomy. Methods. Between January 2013 and April 2017, 12 patients underwent E-VAC therapy for the management of postoperative leakage. Their clinical features and endoscopic procedure details, therapy results, adverse events, and survival were investigated. Results. All 12 patients were male and the median age was 57 years (interquartile range 51.5–62.8 years). The reasons for esophageal surgery were esophageal cancer (83.3%), gastrointestinal stromal tumor (8.3%), and esophageal diverticulum (8.3%). Prior to E-VAC therapy, 6 patients had undergone failed primary surgical repair and the median duration from esophagectomy to leakage discovery was 13.5 days (IQR 6–207 days). The median duration of E-VAC therapy was 25 days (IQR 13.5–34.8 days) and the average sponge exchange rate was 2.7 times during the treatment period. After E-VAC therapy, 8 patients (66.7%) had complete leakage closure, 3 (25%) had a decreased leakage size, and 1 (8.3%) was unchanged. The three patients with a decreased leakage size after E-VAC therapy were treated with endoscopic and conservative management without further surgery. Conclusion. With proper patient selection, E-VAC therapy is a feasible and safe method for the treatment of anastomotic leakage after esophagectomy.

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Effectiveness of Endoluminal Vacuum-assisted Closure Therapy (Endosponge) for the Treatment of Pelvic Anastomotic Leakage After Colorectal Surgery

Surgical Laparoscopy Endoscopy & Percutaneous Techniques ◽

10.1097/sle.0000000000000216 ◽

2015 ◽

Vol 25 (6) ◽

pp. 505-508 ◽

Cited By ~ 11

Author(s):

Metin Keskin ◽

Onur Bayram ◽

Türker Bulut ◽

Emre Balik

Keyword(s):

Colorectal Surgery ◽

Anastomotic Leakage ◽

Vacuum Assisted Closure ◽

Vacuum Assisted Closure Therapy

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PS02.028: RESULTS OF ENDOSCOPIC VACCUM-ASSISTED CLOSURE THERAPY IN THE MANAGEMENT OF POSTOPERATIVE LEAKAGE AFTER ESOPHAGECTOMY

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps02.028 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 128-128

Author(s):

Jae Hyun Jeon ◽

Kwhanmien Kim ◽

Yong Won Seong ◽

Sukki Cho ◽

Sanghoon Jheon

Keyword(s):

Conflicts Of Interest ◽

Therapeutic Option ◽

Oral Feeding ◽

Vacuum Assisted Closure ◽

Vac Therapy ◽

Effective Therapeutic Option ◽

Significant Life ◽

Life Threatening ◽

New Treatment ◽

Postoperative Leakage

Abstract Background Postoperative leakage after esophagectomy is associated with significant life-threatening complications. Recently, endoscopic vacuum-assisted closure (E-VAC) has been introduced and successfully used as a new treatment option. The purpose of this study was to evaluate the safety and efficacy of the E-VAC for the management of postoperative leakage. Methods A total of 22 patients were treated with either intraluminal or intracavitary E-VAC therapy for the management of postoperative leakage from May 2012 to April 2018. The location of leakage was intrathoracic in 17 patients, and cervical in 5. The size of defects was small (< 1 cm) in 8 patients, moderate (1∼2 cm) in 6, and large (> 2 cm) in 5. Outcomes of E-VAC therapy were analyzed retrospectively. Results Complete closure of postoperative leakage was achieved in 19 of 22 patients. The location and size of defects did not affect the success of VAC therapy (all P < 0.05, respectively). The median duration of E-VAC application was 14 days (range 2∼103), and a median of 3 E-VAC systems (range, 1∼14) were used. In 19 patients who were successfully treated with E-VAC, oral feeding was possible on median 15 days after the first day of treatment. There was no mortality related with postoperative leakage. Conclusion E-VAC might be a well-tolerated and effective therapeutic option for the treatment of various postoperative leakage after esophagectomy. Disclosure All authors have declared no conflicts of interest.

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Successful Treatment of Driveline Infection with Vacuum-Assisted Closure Therapy and Instillation Therapy

The Thoracic and Cardiovascular Surgeon Reports ◽

10.1055/s-0040-1713731 ◽

2020 ◽

Vol 09 (01) ◽

pp. e29-e32

Author(s):

Juliane Kilo ◽

Julia Dumfarth ◽

Daniel Höfer ◽

Michael Grimm

Keyword(s):

Local Therapy ◽

Left Ventricular ◽

Vacuum Assisted Closure ◽

Assist Device ◽

Ventricular Assist ◽

Vac Therapy ◽

Instillation Therapy ◽

Left Ventricular Assist ◽

Driveline Infection ◽

Vacuum Assisted Closure Therapy

Abstract Background Driveline infection is a serious complication in left ventricular assist device (LVAD) patients. We report the case of a patient who was successfully treated by combining instillation and vacuum-assisted closure (VAC) therapy. Case Description A 65-year-old LVAD patient presented with recurrent driveline infection. Local therapy with VAC therapy in combination with instillation of polyhexanide was performed for 2 weeks. The patient remains free from infection for twelve months by now. Conclusion This case is the first to present the combination of polyhexanide instillation with VAC as treatment for driveline infection. This therapy may thus be an option for patients who lack any other surgical option.

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Successful Treatment of Anterior Tracheal Necrosis after Total Thyroidectomy Using Vacuum-Assisted Closure Therapy

Critical Care Research and Practice ◽

10.1155/2012/252719 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4

Author(s):

Grégory Philippe ◽

Nicolas Pichon ◽

Justine Lerat ◽

Jean Bernard Amiel ◽

Marc Clavel ◽

...

Keyword(s):

Total Thyroidectomy ◽

Granulation Tissue ◽

Closure Device ◽

Vacuum Assisted Closure ◽

Good Opportunity ◽

Vac Therapy ◽

First Case ◽

Adjacent Structures ◽

Vacuum Assisted Closure Therapy ◽

Ongoing Infection

Total thyroidectomy involving the adjacent structures of the trachea can cause tracheal damage such as early tracheal necrosis. The authors describe the first case of anterior tracheal necrosis following total thyroidectomy treated using vacuum-assisted closure device. After two weeks of VAC therapy, there was no evidence of ongoing infection and the trachea was partially closed around a tracheotomy cannula, removed after 3 months. The use of a VAC therapy to reduce and close the tracheal rent and to create a rapid granulation tissue over tracheal structure appeared as a good opportunity after anterior tracheal necrosis.

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Cost Effectiveness of Vacuum-Assisted Closure and Its Modifications: A Review

ISRN Plastic Surgery ◽

10.5402/2013/595789 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Akhlak Hussain ◽

Kuldip Singh ◽

Mohinder Singh

Keyword(s):

Cost Effectiveness ◽

Negative Pressure ◽

Cost Effective ◽

General Category ◽

Vacuum Assisted Closure ◽

Pressure Therapy ◽

Vac Therapy ◽

Secondary Wound Healing ◽

The Cost ◽

Vacuum Assisted Closure Therapy

Negative topical pressure, the general category to which the trademarked VAC therapy belongs, is not a new concept in wound therapy. It is also called subatmospheric pressure therapy, vacuum sealing, vacuum-assisted closure therapy, vacuum pack therapy, and sealing aspirative therapy. The VAC therapy system is trademarked by Kinetic Concepts, Inc., or KCI. It was first reported in 1997. The aim of the procedure is to use negative pressure to create suction, which drains the wound of exudate (i.e., fluid, cells, and cellular waste that has escaped from blood vessels and seeped into tissue) and influences the shape and growth of the surface tissues in a way that helps healing. Negative-pressure therapy for the closure of wounds accelerates secondary wound healing. High cost is still a hindrance in its use in developing nations. Many modifications were tried, but their efficacy is yet to be proved. In reality, this method is quite cost effective. It is only the lack of understanding and adequate setup which makes this method hard to use. The main objective of this paper is to focus on the cost effectiveness of VAC and its modifications. We want to emphasize the importance of homemade NPT and the use of simple suction devices.

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P-254ENDOSCOPIC VACUUM-ASSISTED CLOSURE THERAPY FOR POSTOPERATIVE LEAKAGE AFTER OESOPHAGEAL RESECTION

Interactive Cardiovascular and Thoracic Surgery ◽

10.1093/icvts/ivw260.251 ◽

2016 ◽

Vol 23 (suppl 1) ◽

pp. i67.3-i67

Author(s):

Hyo-Jun Jang ◽

Y.S. Park ◽

J.E. Han ◽

K. Shin ◽

E. Yi ◽

...

Keyword(s):

Vacuum Assisted Closure ◽

Postoperative Leakage ◽

Vacuum Assisted Closure Therapy

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Vacuum-Assisted Closure Therapy for the Treatment of Poststernotomy Wound Dehiscence in Neonates and Infants

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0037-1603933 ◽

2017 ◽

Vol 67 (01) ◽

pp. 055-057

Author(s):

Massimiliano Carrozzini ◽

Vladimiro Vida ◽

Giovanni Stellin ◽

Massimo Padalino

Keyword(s):

Negative Pressure ◽

Pediatric Patients ◽

Wound Dehiscence ◽

Vacuum Assisted Closure ◽

Median Length ◽

Vac Therapy ◽

Length Of Treatment ◽

Sternal Wound Dehiscence ◽

Neonates And Infants ◽

Vacuum Assisted Closure Therapy

AbstractWe sought to analyze effectiveness and results of a vacuum-assisted closure system for the treatment of sternal wound dehiscence in newborns and children after cardiac surgery in our institution. Six patients with poststernotomy wound problems (large defects of epithelialization or mediastinitis) were treated with a vacuum-assisted closure (VAC) therapy. Median age was 5 months (range: 1–144); VAC therapy was started with negative pressure −75 mm Hg, continuously. All children achieved healing of the sternal wound and a subsequent closure after a median length of treatment of 8.3 days (range: 4–14). In conclusion, VAC therapy with high negative pressure is safe, effective, and is a well-tolerated therapy in pediatric patients with either early- or late poststernotomy wound dehiscence.

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