Endoscopic Vacuum-Assisted Closure (E-VAC) Treatment in a Patient with Delayed Anastomotic Perforation following a Perforated Gastric Conduit Repair after an Ivor-Lewis Esophagectomy

Youn, Heejung; Kwon, Se Hwan

doi:10.5761/atcs.cr.15-00305

Cited by 10 publications

(11 citation statements)

References 10 publications

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“…In recent years, endoscopic vacuum-assisted closure (E-VAC) treatment has been successfully used as a novel endoscopic treatment option for esophageal leaks in adults 1,2 ; however, E-VAC treatment has not been described in children and infants. We report the first case of an infant who was successfully treated by E-VAC for esophageal iatrogenic perforation after thoracoscopic lobectomy.…”

mentioning

confidence: 99%

Endoscopic vacuum sponge therapy for an infant with an esophageal leak

Fraga

Nunes

Andreolio

et al. 2018

The Journal of Thoracic and Cardiovascular Surgery

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mentioning

confidence: 99%

Endoscopic vacuum sponge therapy for an infant with an esophageal leak

Fraga

Nunes

Andreolio

et al. 2018

The Journal of Thoracic and Cardiovascular Surgery

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“…The criteria for selecting the nonsurgical treatment of esophageal perforation have been reported previously [13] . Endoscopic treatments for esophageal perforation have, however, been evolving [15] , [16] , [17] , [18] , [19] . Various options have been reported such as clips [17] , over-the-scope clips (OTSC) [16] , polyglycolic acid (PGA) sheet with fibrin glue [18] , self-expandable metallic stent (SEMS) [15] , and endoscopic vacuum-assisted closure (E-VAC) [19] .…”

Section: Discussionmentioning

confidence: 99%

Difficult to treat esophageal perforation after endoscopic balloon dilation for stenosis due to endoscopic submucosal dissection followed by chemoradiotherapy: A case report

Kitahami

Ishii

Haneda

et al. 2022

International Journal of Surgery Case Reports

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Introduction and importance There is no clear consensus on a specific treatment for esophageal perforation. The surgical approach is deemed necessary for local severe infection and pleural contamination requiring debridement. Presentations of case We have reported herein the case of a patient with esophageal perforation with severe mediastinal and thoracic abscess after endoscopic balloon dilation for stenosis due to endoscopic submucosal dissection and chemoradiotherapy. A surgical approach with primary closure was performed, but not found effective; while conservative treatment with mediastinal drainage via posterior neck and recovery of nutritional status was found to be effective. For the recovery of nutritional status, enteral nutrition was assessed using a polymeric formula through a percutaneous endoscopic gastrojejunostomy tube. Discussion Esophageal perforation is a life-threatening condition. Iatrogenic injuries are the frequent cause of esophageal perforation. For esophageal perforation, not only surgical interventions but also conservative treatments including various endoscopic approaches have been performed. If the inflammation is not localized, surgical intervention is often needed; however, if the patient's general condition is stable, conservative treatment with drainage, antibiotics, and nutritional management may be considered, even in cases of esophageal perforation. Conclusions Esophageal perforation with a large perforation site with widespread inflammation can be improved with proper thoracic and mediastinal drainage and adequate nutrition support if the patient's condition is mild.

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“…Despite these drawbacks, EVAC is emerging as an option for surgeons to employ in the setting of anastomotic leak following esophagectomy. As the technology becomes increasingly widespread, reports of EVAC therapy success following failed attempts at endoluminal stenting are emerging (25,(37)(38)(39). However, we as authors, question the highly selected nature of the patient cohorts in these studies.…”

Section: Evacmentioning

confidence: 99%

Management of anastomotic leaks after esophagectomy and gastric pull-up

Famiglietti¹,

Lazar²,

Henderson³

et al. 2020

J Thorac Dis

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Anastomotic leak is one of the most feared complications of esophagectomy, leading to prolonged hospital stay, increased postoperative mortality, and additional cost both to the patient and the hospital. Historically, anastomotic leaks have been treated with several techniques including conservative measures, percutaneous or operative drainage, primary surgical repair with buttressing, T-tube drainage, or excision of the esophageal replacement conduit with end esophagostomy. With advances in treatment modalities, including endoscopic stenting, clips and suturing, endoluminal vacuum-assisted closure (EVAC), such leaks increasingly are being managed without operative re-intervention and with salvage of the esophageal replacement conduit. For the purposes of this review, we identified studies analyzing the management of postoperative leak after esophagectomy. We then compared the efficacy of the various newer modalities for closure of anastomotic leaks and gastric conduit defects. We found both esophageal stent and EVAC sponges are effective treatments for closure of anastomotic leak. The chosen treatment modality for salvage of the esophageal replacement conduit is entirely dependent on the patient's clinical status and the surgeon's preference and experience. Emerging endoscopic and endoluminal therapies have increased the armamentarium of tools the esophageal surgeon has to facilitate successful resolution of anastomotic leaks following esophagectomy with reconstruction. While some literature suggests that EVACs have a slightly superior result in conduit success, we question this endorsement as EVACs mostly are utilized for contained leaks, many of which may have healed with conservative measures. This poses a challenge as there is clearly a bias given patient selection.

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Endoscopic Vacuum-Assisted Closure (E-VAC) Treatment in a Patient with Delayed Anastomotic Perforation following a Perforated Gastric Conduit Repair after an Ivor-Lewis Esophagectomy

Cited by 10 publications

References 10 publications

Endoscopic vacuum sponge therapy for an infant with an esophageal leak

Endoscopic vacuum sponge therapy for an infant with an esophageal leak

Difficult to treat esophageal perforation after endoscopic balloon dilation for stenosis due to endoscopic submucosal dissection followed by chemoradiotherapy: A case report

Management of anastomotic leaks after esophagectomy and gastric pull-up

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