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Open Access 06-03-2024 | Vacuum Therapy

Endoscopic self-expandable metal stent versus endoscopy vacuum therapy for traumatic esophageal perforations: a retrospective cohort study

Authors: Alessandrino Terceiro de Oliveira, Márcio Alencar Barreira, José Wilson da Cunha Parente Júnior, José Ruver Lima Herculano Junior, Jeany Borges e Silva Ribeiro, Orleancio Gomes Ripardo de Azevedo, Paulo Roberto Cavalcante de Vasconcelos

Published in: Surgical Endoscopy | Issue 4/2024

Abstract

Background

Traumatic esophageal perforations (TEP) are a grave medical condition and require immediate intervention. Techniques such as Esophageal Self-Expandable Metal Stent (E-SEMS) and Endoscopic Vacuum Therapy (EVT) show promise in reducing tissue damage and controlling esophageal leakage. The present study aims to compare the application of EVT to E-SEMS placement in TEP.

Methods

Retrospective cohort study valuated 30 patients with TEP. The E-SEMS and EVT groups were assessed for time of hospitalization, treatment duration, costs, and clinical outcome.

Results

Patients treated with EVT (24.4 ± 13.2) demonstrated significantly shorter treatment duration (p < 0.005) compared to the group treated with E-SEMS (45.8 ± 12.9) and patients submitted to E-SEMS demonstrated a significant reduction (p = 0.02) in the time of hospitalization compared to the EVT (34 ± 2 vs 82 ± 5 days). Both groups demonstrated a satisfactory discharge rate (E-SEMS 93.7% vs EVT 71.4%) but did not show statistically significant difference (p = 0.3155). E-SEMS treatment had a lower mean cost than EVT (p < 0.05). Descriptive statistics were utilized, arranged in table form, where frequencies, percentages, mean, median, and standard deviation of the study variables were calculated and counted. The Fisher's Exact Test was used to evaluate the relationship between two categorical variables. To evaluate differences between means and central points, the parametric t-test was utilized. Comparisons with p value up to 0.05 were considered significant.

Conclusion

E-SEMS showed a shorter time of hospitalization, but a longer duration of treatment compared to EVT. The placement of E-SEMS and EVT had the same clinical outcome. Treatment with E-SEMS had a lower cost compared with EVT.

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Title: Endoscopic self-expandable metal stent versus endoscopy vacuum therapy for traumatic esophageal perforations: a retrospective cohort study
Authors: Alessandrino Terceiro de Oliveira
Márcio Alencar Barreira
José Wilson da Cunha Parente Júnior
José Ruver Lima Herculano Junior
Jeany Borges e Silva Ribeiro
Orleancio Gomes Ripardo de Azevedo
Paulo Roberto Cavalcante de Vasconcelos
Publication date: 06-03-2024
Publisher: Springer US
Keywords: Vacuum Therapy
Vacuum Therapy
Vacuum Therapy
Gunshot Wound
Endoscopy
Published in: Surgical Endoscopy / Issue 4/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-024-10755-5

At a glance: The STEP trials

Springer Medicine

Endoscopic self-expandable metal stent versus endoscopy vacuum therapy for traumatic esophageal perforations: a retrospective cohort study

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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