Successful Closure of Upper GI Leaks by Endoscopic Vacuum Therapy

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S1210
Author(s):  
Timothy S. Yoo ◽  
Adnan Ameer ◽  
Linda A. Hou ◽  
Sofiya Reicher ◽  
Kathryn T. Chen ◽  
...  
Keyword(s):  
Vacuum Therapy ◽  
Upper Gi ◽  
Endoscopic Vacuum Therapy

Endoscopic Internal Drainage and Low Negative Pressure Endoscopic Vacuum Therapy for anastomotic leaks after oncologic upper gastrointestinal surgery

Endoscopy ◽  
2021 ◽  
Author(s):  
Carlo Jung ◽  
Rachel Hallit ◽  
Annegret Müller-Dornieden ◽  
Melanie Calmels ◽  
Diane Goere ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Treatment Duration ◽  
Treatment Success ◽  
Univariate Analysis ◽  
Gastrointestinal Surgery ◽  
Vacuum Therapy ◽  
Internal Drainage ◽  
Upper Gi ◽  
Endoscopic Internal Drainage ◽  
Endoscopic Vacuum Therapy

Background: Endoscopic internal drainage (EID) with double pigtail stents and low negative pressure endoscopic vacuum therapy (EVT) are treatment options for leakages after upper GI oncologic surgery. We aimed to compare the effectiveness of these techniques. Patients and methods: Between 2016 and 2019, patients treated with EID in five centers in France and with EVT in Göttingen, Germany were included and retrospectively analyzed using univariate analysis. Pigtails were changed every 4 weeks, EVT was repeated every 3-4 days until leak closure. Results: 35 EID and 27 EVT patients were included, with a median leak size of 0.75 cm (0.5-1.5). Overall treatment success was 100% [CI 90; 100] in EID vs. 85.2% [CI 66.3; 95.8] in EVT, p=0.03. The median number of endoscopic procedures was 2 (2; 3) vs. 3 (2; 6.5), p<0.01 and the median treatment duration was 42 (28; 60) vs. 17 days (7.5; 28), p<0.01, for EID vs. EVT, respectively. Conclusion: EID and EVT provide high closure rates for upper GI anastomotic leakages. EVT provides a shorter treatment duration at the cost of a higher number of procedures.

478 Surgical Endoscopic Vacuum Therapy for Defects of the Upper GI Tract

2015 ◽  
Vol 148 (4) ◽  
pp. S-1110
Author(s):  
Florian Kuehn ◽  
Florian Janisch ◽  
Frank Schwandner ◽  
Guido Alsfasser ◽  
Leif Schiffmann ◽  
...  
Keyword(s):  
Vacuum Therapy ◽  
Gi Tract ◽  
Upper Gi ◽  
Endoscopic Vacuum Therapy ◽  
Upper Gi Tract

scholarly journals Iatrogenic perforation of esophagus successfully treated with Endoscopic Vacuum Therapy (EVT)

2015 ◽  
Vol 03 (06) ◽  
pp. E547-E551 ◽  
Author(s):  
Gunnar Loske ◽  
Tobias Schorsch ◽  
Christian Dahm ◽  
Eckhard Martens ◽  
Christian Müller
Keyword(s):  
Vacuum Therapy ◽  
Iatrogenic Perforation ◽  
Endoscopic Vacuum Therapy

Feasibility, Effectiveness, and Safety of Endoscopic Vacuum Therapy for Intrathoracic Anastomotic Leakage Following Transthoracic Esophageal Resection: A Prospective Study

2020 ◽  
Author(s):  
Chengcheng Christine Zhang ◽  
Lukas Liesenfeld ◽  
Rosa Klotz ◽  
Ronald Koschny ◽  
Christian Rupp ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Adverse Events ◽  
Anastomotic Leakage ◽  
Esophageal Resection ◽  
Median Number ◽  
Adverse Event Rate ◽  
Vacuum Therapy ◽  
High Morbidity ◽  
Closure Rate ◽  
Endoscopic Vacuum Therapy

Abstract BackgroundAnastomotic leakage (AL) in the upper gastrointestinal (GI) tract is associated with high morbidity and mortality rates. Especially intrathoracic anastomotic leakage leads to life-threatening adverse events. Endoscopic vacuum therapy (EVT) for anastomotic leakage after transthoracic esophageal resection represents a novel concept. However, sound clinical data are still scarce. This prospective, single-center study aimed to evaluate the feasibility, effectiveness, and safety of EVT for intrathoracic anastomotic leakage following abdomino-thoracic esophageal resection. MethodsFrom March 2014 to September 2019 259 consecutive patients underwent elective transthoracic esophageal resection. 72 patients (27,8 %) suffered from AL. The overall collective in-hospital mortality rate was 3.9% (n=10). Data from those who underwent treatment with EVT were included. ResultsFifty-five patients were treated with EVT. Successful closure was achieved in 89.1% (n=49) by EVT only. The EVT-associated adverse event rate was 5.4% (n=3): bleeding occurred in one patient, while minor sedation-related adverse events were observed in two patients. The median number of EVT procedures per patient was 3. The procedures were performed at intervals of 3-5 days, with a 14-day median duration of therapy. The mortality rate of patients with AL was 7.2% (n=4). Despite successfully terminated EVT, three patients died because of multiple organ failure, acute respiratory distress syndrome, and urosepsis (5.4%). One patient (1.8%) died during EVT due to cardiac arrest. ConclusionsEVT is a safe and effective approach for intrathoracic anastomotic leakages following abdomino-thoracic esophageal resections. It offers a high leakage-closure rate and the potential to lower leakage-related mortalities.

Role and possibilities of endoscopic Vacuum Therapy in the treatment of transmural defects of upper gastrointestinal tract

2021 ◽  
pp. 5-16
Author(s):  
Vladimir Alekseevich Porkhanov ◽  
Stanislav Nikolayevich Pyatakov ◽  
Alexander Gennadievich Baryshev ◽  
Denis Mikhailovich Melnik ◽  
Maxim Sergeevich Shevchenko ◽  
...  
Keyword(s):  
Endoscopic Therapy ◽  
Esophageal Wall ◽  
Vacuum Therapy ◽  
Bacterial Clearance ◽  
Surgical Interventions ◽  
Defect Healing ◽  
Effective Instrument ◽  
Endoscopic Vacuum Therapy ◽  
Upper Gastrointestinal

This article describes the clinical case of treatment of a patient with perforation of the esophageal wall and mediastinitis by the method of endoscopic vacuum therapy. Endoscopic Vacuum Therapy, also known as Negative Pressure Endoscopic Therapy (E-NPWT, EVT), is an innovative endoscopic option for the treatment of transmural defects in hollow organs, as well as a safe and effective instrument that promotes defect healing through macrodeformation, microdeformation, perfusion changes, controls exudate and bacterial clearance. The goal of endoscopic vacuum therapy is to avoid radical surgical interventions and their complications, as well as to improve patient’s quality of life in the postoperative period.

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