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Review
. 2024 Jun 27;14(7):821.
doi: 10.3390/life14070821.

VacStent as an Innovative Approach in the Treatment of Anastomotic Insufficiencies and Leakages in the Gastrointestinal Tract-Review and Outlook

Affiliations
Review

VacStent as an Innovative Approach in the Treatment of Anastomotic Insufficiencies and Leakages in the Gastrointestinal Tract-Review and Outlook

Alexander Yohannes et al. Life (Basel). .

Abstract

Anastomotic insufficiencies are severe complications of abdominal surgery, often leading to prolonged hospitalization, serious tissue inflammation, and even sepsis, along with the need for recurrent surgery. Current non-surgical treatments such as self-expanding metal stents (SEMSs) and endoscopic vacuum therapy (EVT) have limitations, including stent migration or perforation. This review evaluates the effectiveness of the VacStent GITM (Möller Medical GmbH, Fulda, Germany), a novel medical device combining SEMS and negative-pressure wound therapy in treating gastrointestinal leaks. Data were gathered from four prospective studies and compared with existing treatments. Studies on the VacStent GITM application demonstrate technical success and competitive closure rates in upper gastrointestinal leaks, with minimal complications reported. Comparative analyses with SEMS and EVT reveal promising and most importantly equally good outcomes while maintaining the possibility for sustained enteral nutrition and reducing the risk of stent migration. The VacStent GITM presents a promising alternative to current non-surgical treatments. Ongoing research aims to validate its efficacy in lower gastrointestinal leaks and comprehensively establish its role in leak management. Further investigation is necessary to confirm these findings and optimize treatment protocols. Future usages of the VacStent GITM in colonic anastomotic insufficiencies promise an effective approach and might be able to lower the rates of necessary implementations of a stoma.

Keywords: VacStent; anastomotic insufficiency; covered stent; endoscopic vacuum therapy; esosponge; gastrointestinal leakage.

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Conflict of interest statement

M.M.H. is a Consultant to Möller Medical GmbH and is an inventor on a Patent to the VacStent. All other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
VacStent GITM: left-side VACStent Colon (inner diameter 25 mm), right-side VACStent Esophagus (inner diameter 12 mm).
Figure 2
Figure 2
PRISMA flow diagram of identification of VacStent studies.

References

    1. Verstegen M.H.P., Slaman A.E., Klarenbeek B.R., van Berge Henegouwen M.I., Gisbertz S.S., Rosman C., van Workum F. Outcomes of Patients with Anastomotic Leakage After Transhiatal, McKeown or Ivor Lewis Esophagectomy: A Nationwide Cohort Study. World J. Surg. 2021;45:3341–3349. doi: 10.1007/s00268-021-06250-w. - DOI - PMC - PubMed
    1. Bachmann J., Feith M., Schlag C., Abdelhafez M., Martignoni M.E., Friess H. Anastomotic leakage following resection of the esophagus-introduction of an endoscopic grading system. World J. Surg. Oncol. 2022;20:104. doi: 10.1186/s12957-022-02551-z. - DOI - PMC - PubMed
    1. de Groot E.M., Bronzwaer S.F.C., Goense L., Kingma B.F., van der Horst S., van den Berg J.W., Ruurda J.P., van Hillegersberg R. Management of anastomotic leakage after robot-assisted minimally invasive esophagectomy with an intrathoracic anastomosis. Dis. Esophagus. 2023;36:doac094. doi: 10.1093/dote/doac094. - DOI - PMC - PubMed
    1. Schafer C. Don’t be afraid of black holes: Vacuum sponge and vacuum stent treatment of leaks in the upper GI tract-a case series and mini-review. Front. Surg. 2023;10:1168541. doi: 10.3389/fsurg.2023.1168541. - DOI - PMC - PubMed
    1. Rausa E., Asti E., Aiolfi A., Bianco F., Bonitta G., Bonavina L. Comparison of endoscopic vacuum therapy versus endoscopic stenting for esophageal leaks: Systematic review and meta-analysis. Dis. Esophagus. 2018;31:doy060. doi: 10.1093/dote/doy060. - DOI - PubMed

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