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

Gastroenterology Research and Practice
Soo Min NohYong-Hee Kim

Abstract

To study the efficacy of E-VAC therapy for patients with anastomotic leakage after esophagectomy. 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. 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. With proper patient selection, E-VAC therapy is a feasib...Continue Reading

References

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Citations

Sep 17, 2020·Annals of the New York Academy of Sciences·Mickael ChevallayStefan Mönig
May 1, 2020·Journal of Surgical Case Reports·Francesco Vito MandarinoLorella Fanti
Jun 18, 2019·World Journal of Gastrointestinal Endoscopy·Diogo Turiani Hourneaux de MouraChristopher C Thompson
Apr 13, 2019·BMC Surgery·Yang Won MinYoung Mog Shim
Oct 13, 2019·World Journal of Surgery·Jae Hyun JeonKwhanmien Kim
Jan 17, 2020·World Journal of Gastrointestinal Endoscopy·Jarosław CwalińskiTomasz Banasiewicz
Jul 19, 2019·Therapeutic Advances in Gastrointestinal Endoscopy·Leonard T WalshMatthew T Moyer
Jan 23, 2021·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Guilherme TavaresWanderley Marques Bernardo
Dec 4, 2020·World Journal of Gastrointestinal Endoscopy·Flaubert Sena de MedeirosEduardo Guimarães Hourneaux de Moura
Dec 11, 2020·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Epifanio Silvino do Monte JuniorEduardo Guimarães Hourneaux de Moura
Dec 29, 2020·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Masaru HayamiMats Lindblad
Dec 22, 2020·Journal of Pediatric Surgery·Jessica L YasudaMichael A Manfredi

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Methods Mentioned

BETA
sedation

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