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. 2023 Sep 28:16:26317745231200312.
doi: 10.1177/26317745231200312. eCollection 2023 Jan-Dec.

Treatment of esophageal leakages with the Microtech®-VAC-Stent: a monocentric early experience of three cases

Michelle A Klose  1 , Jens Walldorf  1 , Marko Damm  1 , Sebastian Krug  1 , Johannes Klose  2 , Ulrich Ronellenfitsch  2 , Joerg Kleeff  2 , Patrick Michl  1 , Jonas Rosendahl  3
Affiliations

Treatment of esophageal leakages with the Microtech®-VAC-Stent: a monocentric early experience of three cases

Michelle A Klose et al. Ther Adv Gastrointest Endosc. .

Abstract

Background: Endoscopic approaches in the treatment of transmural esophageal defects, either after esophageal resection or due to perforation, have demonstrated convincing feasibility. Surgical options are limited and associated with high morbidity and mortality rates. Currently, internal endoscopic drainage with pigtail stents, self-expanding metal stent (SEMS), or endoscopic vacuum therapy (EVT) are options for first-line treatment. Here, we report the outcome of the recently developed combination of SEMS and EVT using the endoscopic Microtech®-VAC-Stent (EVS).

Methods: Between June and July 2022, three consecutive patients (one female and two males) with esophageal transmural defects were treated with the Microtech®-VAC-Stent. Two patients suffered from an anastomotic leak after oncologic gastroesophageal surgery, and one patient presented with esophageal perforation due to Boerhaave syndrome.

Results: Three consecutive patients were successfully treated with EVS. In one patient, one EVS treatment was sufficient, whereas the other two patients needed two and six EVS exchanges. Exchanges were scheduled every 7 days and no procedural adverse events were observed.

Conclusion: In line with the former case series, EVS therapy is a promising new approach for the treatment of esophageal leaks. Exchange of the EVS seems feasible every 7 days reducing interventions for the individual patient. Prospective studies comparing EVS with other endoscopic therapies are needed to define the best therapeutic approach.

Keywords: endoscopic treatment; esophageal leakage; vacuum stent.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Schematic view of the Microtech®-VAC-Stent in full length and special parts depicted in more detail. With permission of MICRO-TECH Europe GmbH.
Figure 2.
Figure 2.
Representative images of the endoscopic picture immediately before initial placement of the Microtech®-VAC-Stent (left) and after removal and termination of stent therapy (right) in all three patients (patient 1 on the top, patient 2 in the middle, and patient 3 at the bottom). Blue arrows show the insufficiency, green arrows mark the Microtech®-VAC-Stent, orange arrows mark the anastomosis region, and dark blue arrows show a residual cavity in patient 2.
See this image and copyright information in PMC

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