Differences in fluid removal of different open-pore elements for endoscopic negative pressure therapy in the upper gastrointestinal tract

Jansen, K.; Hetzel, Jürgen; Schulte, Carola; Düzenli, Nurgül; Fusco, Stefano; Zerabruck, Emanuel; Schmider, Eva; Malek, Nisar P.; Königsrainer, Alfred; Stüker, D; Werner, Christoph R.; Wichmann, Dörte

doi:10.1038/s41598-022-17700-3

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…The most important effect of ENPT in the duodenal position is fluid removal as well as the removal of active digestive enzymes. Especially, the OFD is very suitable in fluid removal ( 2 , 6 ).…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic negative pressure therapy for duodenal leaks

et al. 2023

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Background and study aimEndoscopic negative pressure therapy (ENPT) is well established in the treatment of perforations of various etiologies in the upper and lower gastrointestinal tract. For duodenal perforations exist only case reports and series. Different indications are possible for ENPT in duodenal position: primary therapy for leaks, preemptive therapy after surgery for example, after ulcer suturing or resection with anastomoses, or as second line therapy in cases of recurrent anastomotic insufficiencies with leakage of duodenal secretion.MethodsA retrospective 4-year case series of negative pressure therapy in duodenal position indicated by different etiologies and a comprehensive review of current literature on endoscopic negative pressure duodenal therapy are presented.ResultsPatients with primary duodenal leaks n= 6 and with duodenal stump insufficiencies n = 4 were included. In seven patients ENPT was the first line and sole therapy. Primary surgery for duodenal leak was performed in n = 3 patients. Mean duration of ENPT was 11.0 days, mean hospital stay was 30.0 days. Re-operation after start of ENPT was necessary in two patients with duodenal stump insufficiencies. Surgery after termination of the ENPT was not necessary in any patient.DiscussionIn our case series and in the literature, ENPT has been shown to be very successful in the therapy of duodenal leaks. A challenge in ENPT for duodenal leaks is the appropriate length of the probe to safely reach the leak and keep the open pore element at the end of the probe in place despite intestinal motility.

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Section: Discussionmentioning

confidence: 99%

“…A device composed of an open-pore material, a perforated drain, and a connected negative pressure source is called an open-pore suction device (OPSD) ( 2 ). Endoscopic negative pressure therapy (ENPT) is also known as endoscopic vacuum therapy or endoscopic vacuum-assisted closure.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic negative pressure therapy for duodenal leaks

et al. 2023

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“…Endoscopy also allows us to evaluate the size of the leak and the extension of the collection, as well as perform endoscopic debridement of necrotic tissue. To apply internal EVT, a flexible perforated drainage tube loaded with an open-pore element (sponge or compress) is placed endoscopically within the extramural cavity through the fistula and connected to a vacuum source [ 75 ]. With the active aspiration of necrotic debris and pus into the open-pore element, the cavity walls collapse, and the pores of the sponge become gradually saturated, resulting in less effective negative-pressure application.…”

Section: Endoscopic Vacuum Therapy Principlementioning

confidence: 99%

Endoscopic Vacuum Therapy of Upper Gastrointestinal Anastomotic Leaks: How to Deal with the Challenges (with Video)

Monino

Moreels

2023

Life

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Anastomotic leaks after gastrointestinal surgery have an important impact on surgical outcomes because of the high morbidity and mortality rates. Multiple treatment options exist requiring an individualized patient-tailored treatment plan after multidisciplinary discussion. Endoscopic vacuum therapy (EVT) is a novel treatment option that is nowadays recognized as an effective and useful endoscopic approach to treat leaks or perforations in both the upper and lower gastrointestinal tract. EVT has a very good safety profile. However, it is a time-consuming endeavour requiring engagement from the endoscopist and understanding from the patient. To the unexperienced, the EVT technique may be prone to several hurdles which may deter endoscopists from using it and depriving patients from a potentially life-saving therapeutic option. The current review highlights the possible difficulties of the EVT procedure and aims to provide some practical solutions to facilitate its use in daily clinical practice. Personal tips and tricks are shared to overcome the pre-, intra- and post-procedural hurdles. An instructive video of the procedure helps to illustrate the technique of EVT.

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“…The feasibility and efficacy of this treatment have been demonstrated in small case series for various duodenal defects, including perforated duodenal diverticula, iatrogenic perforations after ERCP or endoscopic mucosal resection, and anastomotic leaks, and it has been a game changer for the minimally invasive treatment of these challenging cases [25, 31–34]. A recent experimental study also showed the high drainage capacity of the OFD, a feature particularly important in the duodenum, where the presence of bile and pancreatic secretions can have a negative effect on tissue healing [35].…”

Section: Clinical Applications and Outcomes Of Ofdmentioning

confidence: 99%

The Role of Open-Pore Film Drainage Systems in Endoscopic Vacuum Therapy: Current Status and Review of the Literature

Kouladouros,

Wichmann,

Loske

2023

Visc Med

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Background: Endoscopic vacuum therapy (EVT) is an increasingly popular endoscopic technique used for the treatment of wall defects in the gastrointestinal tract. Open-pore film drainage (OFD) systems are a new addition to the armamentarium of EVT and have shown encouraging results in a wide spectrum of applications. The aim of this review is to summarize the current literature on the applications of OFD systems in the gastrointestinal tract. Summary: Open-pore film drainage (OFD) systems have been used for the treatment of several defects of the gastrointestinal tract. The small size and easy placement of these devices make them very useful, particularly for the treatment of defects that are small in size or difficult to reach. OFDs have been successfully used for both perforations and anastomotic leaks in various locations, with most reports focusing on the treatment of duodenal defects, although successful applications in the esophagus, stomach, and colon have also been reported. Lately, the role of OFDs in preemptive EVT has also been explored. Key Messages: OFD systems are easy to use, particularly for small defects and challenging localizations. The current literature, consisting mainly of small case series and case reports, shows encouraging results, but further prospective studies are needed to explore and verify the indications and technical aspects of this innovative method.

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Differences in fluid removal of different open-pore elements for endoscopic negative pressure therapy in the upper gastrointestinal tract

Cited by 5 publications

References 23 publications

Endoscopic negative pressure therapy for duodenal leaks

Endoscopic negative pressure therapy for duodenal leaks

Endoscopic Vacuum Therapy of Upper Gastrointestinal Anastomotic Leaks: How to Deal with the Challenges (with Video)

The Role of Open-Pore Film Drainage Systems in Endoscopic Vacuum Therapy: Current Status and Review of the Literature

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