Long-Term Quality of Life Assessment After Successful Endoscopic Vacuum Therapy of Defects in the Upper Gastrointestinal Tract Quality of Life After EVT

Dhayat, Sameer; Schacht, Rosanna; Mennigen, Rudolf; Palmes, Daniel; Vogel, Thomas; Vowinkel, Thorsten; Senninger, N.; Laukoetter, Mike G.

doi:10.1007/s11605-018-4038-9

Cited by 14 publications

(11 citation statements)

References 28 publications

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“…Dhayat et al compared HRQoL of patients after endoscopic vacuum treatment for esophageal perforation or anastomotic leakage after esophagectomy and gastrectomy with patients without leakage [22]. HRQoL was evaluated with the GIQLI questionnaire with a median follow-up of 20 months.…”

Section: Health-related Quality Of Lifementioning

confidence: 99%

Short- and long-term follow-up of patients with non-neoplastic esophageal perforation

Brinkmann

Knepper

Fuchs

et al. 2021

Langenbecks Arch Surg

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Purpose Esophageal perforation is associated with high morbidity and mortality. In addition to surgical treatment, endoscopic endoluminal stent placement and endoscopic vacuum therapy (EVT) are established methods in the management of this emergency condition. Although health-related quality of life (HRQoL) is becoming a major issue in the evaluation of any therapeutic intervention, not much is known about HRQoL, particularly in the long-term follow-up of patients treated for non-neoplastic esophageal perforation with different treatment strategies. The aim of this study was to evaluate patients’ outcome after non-neoplastic esophageal perforation with focus on HRQoL in the long-term follow-up. Methods Patients treated for non-neoplastic esophageal perforation at the University Hospital Cologne from January 2003 to December 2014 were included. Primary outcome and management of esophageal perforation were documented. Long-term quality of life was assessed using the Gastrointestinal Quality of Life Index (GIQLI), the Health-Related Quality of Life Index (HRQL) for patients with gastroesophageal reflux disease (GERD), and the European Organization for Research and Treatment of Cancer (EORTC) questionnaires for general and esophageal specific QoL (QLQ-C30 and QLQ-OES18). Results Fifty-eight patients were included in the study. Based on primary treatment, patients were divided into an endoscopic (n = 27; 46.6%), surgical (n = 20; 34.5%), and a conservative group (n = 11; 19%). Short- and long-term outcome and quality of life were compared. HRQoL was measured after a median follow-up of 49 months. HRQoL was generally reduced in patients with non-neoplastic esophageal perforation. Endoscopically treated patients showed the highest GIQLI overall score and highest EORTC general health status, followed by the conservative and the surgical group. Conclusion HRQoL in patients with non-neoplastic esophageal perforation is reduced even in the long-term follow-up. Temporary stent or EVT is effective and provides a good alternative to surgery, not only in the short-term but also in the long-term follow-up.

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Section: Health-related Quality Of Lifementioning

confidence: 99%

Short- and long-term follow-up of patients with non-neoplastic esophageal perforation

Brinkmann

Knepper

Fuchs

et al. 2021

Langenbecks Arch Surg

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“…A great disadvantage of E-VAC is the necessity for multiple endoscopic procedures, which requires a considerable commitment. A recent study, however, shows that the use of E-VAC for transmural upper GI defects is well tolerated by the patient, with a satisfactory long term quality of life [ 10 ]. To our knowledge this is the first report on the use of this device to treat the gastric conduit perforation after esophagectomy.…”

Section: Discussionmentioning

confidence: 99%

Gastric conduit perforation after Ivor Lewis esophagectomy successfully treated with endoscopic vacuum therapy (E-VAC): a case report

Hetoja

Pasqual

Mengardo

et al. 2020

Journal of Surgical Case Reports

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Gastric conduit perforation is a life-threatening complication after esophagectomy and currently there is no consensus about its optimal management. Endoscopic vacuum therapy (E-VAC) is a promising technique for the treatment of leaks and perforations after upper gastro-intestinal surgery. We report the case of a 65 years-old male patient who underwent an Ivor Lewis esophagectomy for esophago-gastric junction adenocarcinoma. He referred to our Emergency Department for septic shock and right hydropneumothorax. We performed an emergency thoracoscopy with intraoperative esophagogastroduodenoscopy which showed a pre-pyloric perforation of the gastric conduit. The perforation was initially treated with unsuccessful primary surgical closure and subsequently by means of E-VAC, firstly placed intraluminal and then intracavitary. With the latter technique, we assisted to a progressive clinical improvement until the definitive healing of the perforation. To our knowledge, this is the first case of a gastric tube perforation after esophagectomy successfully treated with E-VAC.

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“…Surprisingly, the results showed that patients who had undergone EVT following an anastomotic leak had better HRQOL scores than those without. Similarly, Dhavat et al [ 39 ] did a prospective survey to compare the gastrointestinal quality of life index (GIQLI) between patients treated with EVT and those treated with esophagectomy but did not experience any leak. The median GIQLI score was lower in patients who underwent EVT treatment (83 vs 96.5, p =0.185) but comparable between groups for most domains assessed, including symptoms and physical functions.…”

Section: Efficacymentioning

confidence: 99%

Current Status of Endoscopic Vacuum Therapy in the Management of Esophageal Perforations and Post-Operative Leaks

et al. 2021

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Esophageal wall defects, including perforations and postoperative leaks, are associated with high morbidity and mortality and pose a significant management challenge. In light of the high morbidity of surgical management or revision, in recent years, endoscopic vacuum therapy (EVT) has emerged as a novel alternative treatment strategy. EVT involves transoral endoscopic placement of a polyurethane sponge connected to an externalized nasogastric tube to provide continuous negative pressure with the intention of promoting defect healing, facilitating cavity drainage, and ameliorating sepsis. In the last decade, EVT has become increasingly adopted in the management of a diverse spectrum of esophageal defects. Its popularity has been attributed in part to the growing body of evidence suggesting superior outcomes and defect closure rates in excess of 80%. This growing body of evidence, coupled with the ongoing evolution of the technology and techniques of deployment, suggests that the utilization of EVT has become increasingly widespread. Here, we aimed to review the current status of the field, addressing the mechanism of action, indications, technique methodology, efficacy, safety, and practical considerations of EVT implementation. We also sought to highlight future directions for the use of EVT in esophageal wall defects.

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Long-Term Quality of Life Assessment After Successful Endoscopic Vacuum Therapy of Defects in the Upper Gastrointestinal Tract Quality of Life After EVT

Cited by 14 publications

References 28 publications

Short- and long-term follow-up of patients with non-neoplastic esophageal perforation

Short- and long-term follow-up of patients with non-neoplastic esophageal perforation

Gastric conduit perforation after Ivor Lewis esophagectomy successfully treated with endoscopic vacuum therapy (E-VAC): a case report

Current Status of Endoscopic Vacuum Therapy in the Management of Esophageal Perforations and Post-Operative Leaks

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