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. 2023 Nov;56(6):754-760.
doi: 10.5946/ce.2022.177. Epub 2023 May 9.

Endoscopic vacuum therapy for treatment of spontaneous and iatrogenic upper gastrointestinal defects

Kavea Panneerselvam  1 , Jake S Jacob  2 , Ronald E Samuel  2 , Andy Tau  3 , Gyanprakash A Ketwaroo  2 , Wasif M Abidi  2 , Robert J Sealock  2
Affiliations

Endoscopic vacuum therapy for treatment of spontaneous and iatrogenic upper gastrointestinal defects

Kavea Panneerselvam et al. Clin Endosc. 2023 Nov.

Abstract

Background/aims: Endoscopic vacuum therapy (EVT) can heal a variety of defects within the gastrointestinal (GI) tract via applying negative pressure, which reduces the defect size, aspirates the infected fluid, and promotes granulation tissue. Here we present our experience with EVT as it relates to both spontaneous and iatrogenic upper GI tract perforations, leaks, and fistulas.

Methods: This retrospective study was conducted at four large hospital centers. All patients who underwent EVT between June 2018 and March 2021 were included. Data on multiple variables were collected, including demographics, defect size and location, number and intervals of EVT exchanges, technical success, and hospital length of stay. Student t-test and the chi-squared test were used to analyze the data.

Results: Twenty patients underwent EVT. The most common defect cause was spontaneous esophageal perforation (50%). The most common defect location was the distal esophagus (55%). The success rate was 80%. Seven patients were treated with EVT as the primary closure method. The mean number of exchanges was five with a mean interval of 4.3 days between exchanges. The mean length of hospital stay was 55.8 days.

Conclusion: EVT is a safe and effective initial management option for esophageal leaks and perforations.

Keywords: Esophagus; Fistula; Vacuum.

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Conflict of interest statement

Conflicts of Interest

The authors have no potential conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Constructed endoscopic vacuum therapy apparatus.
Fig. 2.
Fig. 2.
Illustration of endoscopic vacuum therapy (EVT) case series. Relative width of base of each bar represents defect size. Cases with complete closure achieved are represented by triangles, and those without complete closure with rectangles. Dotted lines represent mean time of exchange.
None
See this image and copyright information in PMC

References

    1. Fleischmann W, Strecker W, Bombelli M, et al. Vacuum sealing as treatment of soft tissue damage in open fractures. Unfallchirurg. 1993;96:488–492. - PubMed
    1. Abdulsada M, Sealock RJ, Cornwell L, et al. Endoluminal vacuum therapy of esophageal perforations. VideoGIE. 2019;5:8–10. - PMC - PubMed
    1. Weidenhagen R, Gruetzner KU, Wiecken T, et al. Endoscopic vacuum-assisted closure of anastomotic leakage following anterior resection of the rectum: a new method. Surg Endosc. 2008;22:1818–1825. - PubMed
    1. Wedemeyer J, Schneider A, Manns MP, et al. Endoscopic vacuum-assisted closure of upper intestinal anastomotic leaks. Gastrointest Endosc. 2008;67:708–711. - PubMed
    1. Kuehn F, Loske G, Schiffmann L, et al. Endoscopic vacuum therapy for various defects of the upper gastrointestinal tract. Surg Endosc. 2017;31:3449–3458. - PubMed

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