Abstract:Esophageal wall defects of different etiology in the upper gastrointestinal tract can be treated successfully with EVT, considering that indication for EVT should be weighed carefully. EVT can be regarded as a novel life-saving therapeutic tool.
“…Our positive results were then confirmed in several retrospective studies predominantly conducted in German departments of surgery with surgical endoscopy expertise [3]. Individual working groups within these departments have already reported on significant sample sizes of between 35 and 77 patients, demonstrating the value placed on the innovative method within this short period [4–6]. Treatment success requires expertise in both surgical wound treatment and in flexible endoscopy examination techniques.…”
Section: Flexible Endoscopy In Surgerysupporting
confidence: 68%
“…When performing this procedure, we follow a treatment algorithm (Fig. 1; [4]), which has also been adopted by other users [5, 6]. Fig.…”
Section: Endoscopy Of Gastrointestinal Leaksmentioning
confidence: 99%
“…We do not rinse the drain prior to removal. There have been rare reports of bleeding complications due to erosions when using OPDs for extraluminal intracavitary ENPT in esophageal defects [6, 9]. Fig.…”
Section: Open-pore Polyurethane Foams Erosive Suction Patterns and mentioning
Endoscopic negative-pressure therapy (ENPT) is becoming a valuable tool in surgical complication management of transmural intestinal defects and wounds in the upper and lower gastrointestinal tract. Innovative materials for drains have been developed, endoscopic techniques adapted, and new indications for ENPT have been found. Based on our broad clinical experience, numerous tips and tricks are described, which contribute to the safety of dealing with the new therapy. The aim of this work is to present these methods. The focus is on describing the treatment in the esophagus.
“…Our positive results were then confirmed in several retrospective studies predominantly conducted in German departments of surgery with surgical endoscopy expertise [3]. Individual working groups within these departments have already reported on significant sample sizes of between 35 and 77 patients, demonstrating the value placed on the innovative method within this short period [4–6]. Treatment success requires expertise in both surgical wound treatment and in flexible endoscopy examination techniques.…”
Section: Flexible Endoscopy In Surgerysupporting
confidence: 68%
“…When performing this procedure, we follow a treatment algorithm (Fig. 1; [4]), which has also been adopted by other users [5, 6]. Fig.…”
Section: Endoscopy Of Gastrointestinal Leaksmentioning
confidence: 99%
“…We do not rinse the drain prior to removal. There have been rare reports of bleeding complications due to erosions when using OPDs for extraluminal intracavitary ENPT in esophageal defects [6, 9]. Fig.…”
Section: Open-pore Polyurethane Foams Erosive Suction Patterns and mentioning
Endoscopic negative-pressure therapy (ENPT) is becoming a valuable tool in surgical complication management of transmural intestinal defects and wounds in the upper and lower gastrointestinal tract. Innovative materials for drains have been developed, endoscopic techniques adapted, and new indications for ENPT have been found. Based on our broad clinical experience, numerous tips and tricks are described, which contribute to the safety of dealing with the new therapy. The aim of this work is to present these methods. The focus is on describing the treatment in the esophagus.
“…Among endoscopic interventions, endoscopic vacuum therapy (EVT)/endosponge therapy (EST) seems to be more favorable and technically easier as compared with the use of self‐expandable metal stents (SEMSs) . Current data regarding outcomes of EVT/EST versus SEMS do not differentiate between cervical and intrathoracic anastomotic insufficiency and include mixed cohorts, including Ivor Lewis (intrathoracic anastomosis) and McKeown (cervical anastomosis) esophagectomies, as well as gastrectomies .…”
Despite improvements in operative strategies for esophageal resection, anastomotic leaks, fistula, postoperative pulmonary complications, and chylothorax can occur. Our review seeks to identify potential risk factors, modalities for early diagnosis, and novel interventions that may ameliorate the potential adverse effects of these surgical complications following esophagectomy.
“…A further case report described the successful use in an infant [43]. Reports of bleeding complications [11, 21] or serious complications in intracavitary ENPT are rare.…”
Endoscopic negative pressure therapy (ENPT) has been adapted for upper gastrointestinal tract applications. More than 400 patients have already been treated with ENPT due to transmural defects in the upper gastrointestinal tract, with a success rate of 87%. The greatest experience exists for the treatment of anastomotic leakages and perforations of the esophagus. The ENPT is also used in the duodenum, pancreas and for complications after bariatric surgery. There are new indications that go beyond treatment in complication management. Innovative drainage types and endoscopic techniques have been developed that broaden the spectrum of applications. The aim of this article is to give an overview of the current status of ENPT in the upper gastrointestinal tract.
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