Endoscopic vacuum sponge therapy for esophageal defects

Loske, Gunnar; Schorsch, Tobias; Müller, Christian

doi:10.1007/s00464-010-0998-x

Cited by 97 publications

(76 citation statements)

References 22 publications

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“…Of interest, we observed that ultrasound-guided percutaneous drainages or endoscopic transluminal drainages [30] have been more commonly employed during recent years, both as a supplement to surgery, and sometimes instead of operative treatment. It has recently been suggested that a number of contemporary non-operative techniques, including clips [31], stents [32,33,34], and vacuum therapies [35,36], be used both as primary treatment for the perforation and as secondary tools when complications occur. These techniques are regarded as feasible and promising; however, the overall clinical experience is limited, and most related publications are case series with very few patients.…”

Section: Discussionmentioning

confidence: 99%

Esophageal Perforation: Clinical Patterns and Outcomes from a Patient Cohort of Western Norway

Søreide

Sandvik

et al. 2012

Dig Surg

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Background: Esophageal perforation is a rare, often life-threatening condition, and management remains challenging. Methods: Retrospective review of consecutive patients with esophageal perforation treated at two university hospitals between 2000 and 2010. Pertinent data from hospital records were retrieved for statistical calculations and evaluation of perforation score. Results: Forty-seven patients [47% female, median age 62 years (range 15–88)] were included. The annual incidence was 4.7/1,000,000. Perforations were spontaneous in 14 patients (30%), iatrogenic in 25 (53%), and caused by trauma and foreign body impaction in 8 patients (17%). ASA score (p = 0.004), perforation localization (p = 0.001), diagnostic delay (p = 0.002), and perforation score (p < 0.001) differed significantly between patient groups with different etiology, but not between groups with different outcomes. Early diagnosis (≤24 h) was significantly associated with a low perforation score (p = 0.033). A non-operative approach was employed in 26 patients (55%) – more commonly for proximally localized perforations (p = 0.045). The non-operative group showed lower severe complication rates (p = 0.033), shorter ICU stays (p < 0.001) and durations of mechanical ventilation (p = 0.022). The overall 30-day mortality was 23.4%. Conclusion: Careful clinical evaluation and appropriate, individualized treatment are important. The high mortality may be partly explained by the underlying disease and the complexity of the clinical condition in many patients.

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Section: Discussionmentioning

confidence: 99%

Esophageal Perforation: Clinical Patterns and Outcomes from a Patient Cohort of Western Norway

Søreide

Sandvik

et al. 2012

Dig Surg

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“…4) E-VAC for the treatment of esophageal perforation has been reported after this successful E-VAC treatment for anastomotic leakage after anterior resection of the rectum. [4][5][6] The key concepts of EVAC treatment on esophageal perforation consist of the sealing of the esophageal perforation to prevent the abscess spreading and continuous internal drainage of septic debris from abscess cavity through the polyurethane spongeheaded nasogastric tube. The polyurethane sponge head could be located in mediastinal abscess cavity, intracavitary, or esophageal lumen with sealing the perforation, intraluminary, depending on the abscess cavity size and shape.…”

Section: Discussionmentioning

confidence: 99%

“…Eventually, this facilitates a clean wound base and improves consecutive wound closure. [4][5][6] We inserted the sponge-headed nasogastric tube tip into the anastomotic perforation site under endoscopy. The sponge headed nasogastric tube could occlude the perforation site intraluminary.…”

Section: Case Reportmentioning

confidence: 99%

“…Recently, endoscopic vacuum-assisted closure (E-VAC) introduced as a treatment option for esophageal perforations. [4][5][6] We here report the case of a patient with achalasia and esophageal cancer who experienced perforation of the remaining esophagus following primary repair of a gastric conduit perforation after an Ivor-Lewis esophagectomy who was successfully treated by E-VAC.…”

Section: Introductionmentioning

confidence: 99%

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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

Youn

Kwon

2016

ATCS

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It has been reported that intrathoracic esophageal leakages occur at a rate of 4%-17% after Ivor-Lewis esophagectomy. There has been no consensus on a specific treatment for the post-operative anastomotic leakage. Recently, endoscopic vacuum-assisted closure (E-VAC) has been introduced as a novel treatment for the post-operative anastomotic leakage. We herein report the case of a patient with early perforation of the gastric conduit followed by late esophagogastric anastomotic leakage who was successfully treated with early surgical repair and subsequent E-VAC. The patient had been previously diagnosed with achalasia and squamous cell carcinoma of the esophagus and undergone an Ivor-Lewis esophagectomy.

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“…The technique inaugurated by us allows sponge placement under full visualization. An intraluminal therapy variation combines the surgical principle of complete occlusion and sufficient internal drainage [12]. We present the first description of successful endoscopic intraluminal vacuum therapy in the treatment of complete esophageal anastomotic necrosis.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Intraluminal Vacuum Therapy of Complete Esophageal-Jejunal Anastomotic Rupture: A Case Report

Loske¹,

Schorsch²

2011

Viszeralmedizin

Self Cite

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Objective: Anastomotic failure after gastric resection is a severe postoperative complication. The endoscopic vacuum-assisted treatment of anastomotic leakage of the rectum is an effective method that has been demonstrated recently. We inaugurated an intraluminal variant of the method and endoscopic procedures allowing the placement of the vacuum drainage under full visualisation. This report decribes the successful endoscopic treatment of a case of complete esophageal anastomotic rupture. Case Report: A 67-year-old male patient with gastric cancer developed a complete necrosis of the esophageal-jejunal anastomosis after abdomino-transhiatal gastrectomy. Remission of the symptoms could be achieved by intraluminal vacuum therapy within 20 days, using a polyurethane sponge-tipped drainage connected to a vacuum device applying 125 mm Hg of continuous negative pressure. Conclusion: The intraluminal vacuum therapy represents an innovative method that combines the surgical principle of complete intestinal occlusion with efficient intraluminal drainage of the extraluminal inflammative focus.

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Endoscopic vacuum sponge therapy for esophageal defects

Abstract: Esophageal anastomotic insufficiency and esophageal wall defects of other causes can be treated successfully with endoscopic vacuum sponge therapy.

Cited by 97 publications

References 22 publications

Esophageal Perforation: Clinical Patterns and Outcomes from a Patient Cohort of Western Norway

Esophageal Perforation: Clinical Patterns and Outcomes from a Patient Cohort of Western Norway

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

Endoscopic Intraluminal Vacuum Therapy of Complete Esophageal-Jejunal Anastomotic Rupture: A Case Report

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