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01-04-2018

Results of endoscopic vacuum-assisted closure device for treatment of upper GI leaks

Authors: Marc Bludau, Hans F. Fuchs, Till Herbold, Martin K. H. Maus, Hakan Alakus, Felix Popp, Jessica M. Leers, Christiane J. Bruns, Arnulf H. Hölscher, Wolfgang Schröder, Seung-Hun Chon

Published in: Surgical Endoscopy | Issue 4/2018

Abstract

Background

Esophageal perforations and postoperative leakage of esophagogastrostomies are considered to be life-threatening conditions due to the potential development of mediastinitis and consecutive sepsis. Vacuum-assisted closure (VAC) techniques, a well-established treatment method for superficial infected wounds, are based on a negative pressure applied to the wound via a vacuum-sealed sponge. Endoluminal VAC (E-VAC) therapy as a treatment for GI leakages in the rectum was introduced in 2008. E-VAC therapy is a novel method, and experience regarding esophageal applications is limited. In this retrospective study, the experience of a high-volume center for upper GI surgery with E-VAC therapy in patients with leaks of the upper GI tract is summarized. To our knowledge, this series presents the largest patient cohort worldwide in a single-center study.

Methods

Between October 2010 and January 2017, 77 patients with defects in the upper gastrointestinal tract were treated using the E-VAC application. Six patients had a spontaneous perforation, 12 patients an iatrogenic injury, and 59 patients a postoperative leakage in the upper gastrointestinal tract.

Results

Complete restoration of the esophageal defect was achieved in 60 of 77 patients. The average duration of application was 11.0 days, and a median of 2.75 E-VAC systems were used. For 21 of the 77 patients, E-VAC therapy was combined with the placement of self-expanding metal stents.

Conclusion

This study demonstrates that E-VAC therapy provides an additional treatment option for esophageal wall defects. Esophageal defects and mediastinal abscesses can be treated with E-VAC therapy where endoscopic stenting may not be possible. A prospective multi-center study has to be directed to bring evidence to the superiority of E-VAC therapy for patients suffering from upper GI defects.

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Title: Results of endoscopic vacuum-assisted closure device for treatment of upper GI leaks
Authors: Marc Bludau
Hans F. Fuchs
Till Herbold
Martin K. H. Maus
Hakan Alakus
Felix Popp
Jessica M. Leers
Christiane J. Bruns
Arnulf H. Hölscher
Wolfgang Schröder
Seung-Hun Chon
Publication date: 01-04-2018
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 4/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-017-5883-4

ACC 2024 Congress

Springer Medicine

Results of endoscopic vacuum-assisted closure device for treatment of upper GI leaks

Abstract

Background

Methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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