Endoluminal vacuum-assisted closure (E-Vac) therapy for postoperative esophageal fistula: successful case series and literature review

Abstract Background Treatment of esophageal perforations and postoperative anastomotic leaks of the upper gastrointestinal tract remains a challenge. Endoluminal vacuum-assisted closure (E-Vac) therapy has positively contributed, in recent years, to the management of upper gastrointestinal tract perforations by using the same principle of vacuum-assisted closure therapy of external wounds. The aim is to provide continuous wound drainage and to promote tissue granulation, decreasing the needed time to heal with a high rate of leakage closure. Cases presentation A series of two different cases with clinical and radiological diagnosis of esophageal fistulas, recorded from 2018 to 2019 period at our institution, is presented. The first one is a case of anastomotic leak after esophagectomy for cancer complicated by pleuro-mediastinal abscess, while the second one is a leak of an esophageal suture, few days after resection of a bronchogenic cyst perforated into the esophageal lumen. Both cases were successfully treated with E-Vac therapy. Conclusion Our experience shows the usefulness of E-Vac therapy in the management of anastomotic and non-anastomotic esophageal fistulas. Further research is needed to better define its indications, to compare it to traditional treatments and to evaluate its long-term efficacy.

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Endoluminal Vacuum Assisted Closure (E-Vac) Therapy for Postoperative Esophageal Fistula: Successful Case Series and Literature Review

10.21203/rs.3.rs-34105/v1 ◽

2020 ◽

Author(s):

Carolina Rubicondo ◽

Andrea Lovece ◽

Domenico Pinelli ◽

Amedeo Indriolo ◽

Alessandro Lucianetti ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Case Series ◽

High Rate ◽

Upper Gastrointestinal Tract ◽

Vacuum Assisted Closure ◽

Vac Therapy ◽

Esophageal Lumen ◽

Esophageal Perforations ◽

Esophagectomy For Cancer ◽

Upper Gastrointestinal

Abstract Background: Treatment of esophageal perforations and postoperative anastomotic leaks of the upper gastrointestinal tract remains a challenge. Endoluminal vacuuma assisted closure (E-vac) therapy has positively contributed, in recent years, to the management of upper gastrointestinal tract perforations by using the same principle of vacuum assisted closure therapy of external wounds. The aim is to provide continuous wound drainage and to promote tissue granulation, decreasing the needed time to heal with a high rate of leakage closure.Report of cases: A series of two different cases with clinical and radiological diagnosis of esophageal fistulas, recorded during the 2018 to 2019 period at our institution, is presented. The first one is a case of anastomotic leak after esophagectomy for cancer complicated by pleuro-mediastinal abscess; while the second one is a leak of an esophageal suture, few days after resection of a bronchogenic cyst perforated into the esophageal lumen. Both cases were successfully treated with E-vac therapy.Conclusion: Our results confirm the usefulness of E-vac therapy in the management of anastomotic and non-anastomotic esophageal fistulas. Further research is needed to better define its indications, to compare it to traditional treatments and to evaluate its long-term efficacy.

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Gallstone ileus of upper gastrointestinal tract: A case series

Indian Journal of Gastroenterology ◽

10.1007/s12664-019-00954-7 ◽

2019 ◽

Vol 38 (3) ◽

pp. 273-275

Author(s):

Mohammad Ibrarullah ◽

Pramod K. Samantaray ◽

Sadananda Meher ◽

Wani Hamza Bruno

Keyword(s):

Gastrointestinal Tract ◽

Gallstone Ileus ◽

Case Series ◽

Upper Gastrointestinal Tract ◽

Upper Gastrointestinal

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Cytomegalovirus disease of the upper gastrointestinal tract in patients with rheumatic diseases: a case series and literature review

Clinical Rheumatology ◽

10.1007/s10067-013-2363-7 ◽

2013 ◽

Vol 32 (11) ◽

pp. 1683-1690 ◽

Cited By ~ 29

Author(s):

Takashi Ozaki ◽

Hiroyuki Yamashita ◽

Shunta Kaneko ◽

Hideki Yorifuji ◽

Hiroyuki Takahashi ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Literature Review ◽

Rheumatic Diseases ◽

Case Series ◽

Upper Gastrointestinal Tract ◽

Cytomegalovirus Disease ◽

Upper Gastrointestinal

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Implementation of endoscopic submucosal dissection for early upper gastrointestinal tract cancer after primary experience in colorectal endoscopic submucosal dissection

Endoscopy International Open ◽

10.1055/a-0854-3610 ◽

2019 ◽

Vol 07 (04) ◽

pp. E446-E451 ◽

Cited By ~ 1

Author(s):

Lena Mocker ◽

Ralf Hildenbrand ◽

Tsuneo Oyama ◽

Bernd Sido ◽

Naohisa Yahagi ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Endoscopic Submucosal Dissection ◽

Curative Resection ◽

Case Series ◽

Upper Gastrointestinal Tract ◽

Western World ◽

Minimal Risk ◽

Retrospective Case ◽

Submucosal Dissection ◽

Upper Gastrointestinal

Abstract Background Current guidelines recommend endoscopic submucosal dissection (ESD) as a treatment option for early cancers of the upper gastrointestinal tract with absent or minimal risk of lymph node metastasis. However, due to the low prevalence of these entities, it is difficult to achieve a competence level for ESD of upper gastrointestinal tract cancers in the Western World. Here, we present single-center data on the implementation of upper gastrointestinal ESD after previous experience with 89 colorectal ESD cases. Methods Retrospective case series of 39 consecutive patients with early cancers of the esophagus (n = 13) or cardia and stomach (n = 26) treated with ESD over a 4-year period. Results ESD was technically feasible in all cases with en bloc, R0, and curative resection rates of 100 %, 76.9 %, and 71.8 %, respectively, and a mean procedure time of 100 minutes (30 – 360 minutes). After an initial 20 procedures, the R0 and curative resection rates increased from 65.0 % to 89.5 %, and from 60.0 % to 84.2 %, respectively. Complications were observed in four patients (10.3 %): three perforations, one case of delayed bleeding, and one esophageal stricture. No case required emergency surgery; the 30-day mortality rate was 0 %. Conclusion In this modest case series from Europe, we observed an effectiveness and complication rate for ESD for early esophageal and gastric cancer that are comparable to other series from Europe but also to more abundant data from Asia. The results indicate that even small numbers of upper gastrointestinal cancers can be managed adequately in centers with expertise in colorectal ESD.

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Formation of the upper gastrointestinal tract for patients who underwent total esophago-gastrectomy due to caustic ingestion: Case series

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2021.102846 ◽

2021 ◽

Vol 70 ◽

pp. 102846

Author(s):

Tran Manh Hung ◽

Thi Phuong Thao Tran ◽

Nguyen Trung Kien ◽

Tran Thi Phuong

Keyword(s):

Gastrointestinal Tract ◽

Case Series ◽

Upper Gastrointestinal Tract ◽

Caustic Ingestion ◽

Upper Gastrointestinal

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Application of the Vienna Classificaton for Crohn's Disease to a Single Clinician Database of 877 Patients

Canadian Journal of Gastroenterology ◽

10.1155/2001/426968 ◽

2001 ◽

Vol 15 (2) ◽

pp. 89-93 ◽

Cited By ~ 32

Author(s):

Hugh James Freeman

Keyword(s):

Crohn’S Disease ◽

Gastrointestinal Tract ◽

Crohn's Disease ◽

Terminal Ileum ◽

Tertiary Care ◽

Working Party ◽

High Rate ◽

Upper Gastrointestinal Tract ◽

Disease Location ◽

Upper Gastrointestinal

An international working party at the World Congress of Gastroenterology held in Vienna, Austria from September 6 to 11, 1998 defined a classification for Crohn's disease based on patient age at diagnosis (eg, less than 40 years of age, 40 years of age or older), disease location (eg, terminal ileum, colon, ileocolon or upper gastrointestinal tract) and behaviour (eg, stricturing, penetrating). Disease location in the upper gastrointestinal tract was defined by disease being present proximal to the terminal ileum, regardless of terminal ileal or colon involvement. A 20-year, single clinician database of 877 patients from a university campus hospital was used, and comprised 492 women (56.1%) and 385 men (43.9%). Of these patients, 740 (84.4%) were diagnosed before age 40 years and 137 (15.6%) were diagnosed by 40 years of age or older. Disease was located in the terminal ileum alone in 222 patients (25.3%), colon alone in 238 patients (27.2%) and ileocolon in 304 patients (34.6%). Another 113 patients (13.1%) had disease in the upper gastrointestinal tract, usually with disease also in the terminal ileum (23 patients), colon (12 patients) or ileocolon (71 patients). Only seven of 877 patients had disease located in the upper gastrointestinal tract alone with no distal disease. Disease behaviour could be classified as nonstricturing and nonpenetrating in 256 patients (29.2%), stricturing in 294 patients (33.6%) and penetrating in 327 patients (37.2%). Of the 877 patients with Crohn's disease, 837 were white, 38 were Asian and two were black. In this tertiary care setting of a single clinician practice in a Canadian teaching hospital at the University of British Columbia, Crohn's disease predominantly affects women, and young adults with a high rate of stricturing and penetrating complications.

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