Endoskopische Vakuumtherapie von Perforationen und Anastomoseninsuffizienzen des Ösophagus

Abstract

The results of this retrospective study emphasize the increasing importance of endoscopic vacuum therapy in the current literature as an endoscopic treatment method in the management of esophageal perforation and anastomotic leakage.

The use of endoluminal vacuum (E-Vac) therapy in the management of upper gastrointestinal leaks and perforations

“…The average duration of E-Vac therapy (35.8 days) in our study was longer than the average duration of therapy in the other E-Vac studies (range 11-28 days) [8,10,11,[13][14][15]. One contributing factor for this difference could be our foam change interval.…”

“…Closure rates were shown in six of the seven studies. The average closure rate of these six studies was 89.2 % (91/102 patients, range 84.4-100 %) [8,10,11,[13][14][15]. Mortality rates were reported in all seven studies and the average mortality rate was 10.1 % (12/119 patients, range 0-15.6 %) [8,[10][11][12][13][14][15].…”

“…In our review of the literature we found seven major studies (case series with five or more patients) using E-Vac therapy to treat esophageal leaks and perforations [8,[10][11][12][13][14][15]. Closure rates were shown in six of the seven studies.…”

“…Both improve and accelerate healing by removing infected secretions, reducing edema, increasing local perfusion, and promoting granulation tissue formation [8,9]. E-Vac therapy has been shown to successfully close esophageal perforations and leaks with low mortality rates [8][9][10][11][12][13][14][15]. All reported studies have come from German institutions.…”

Tips and tricks for endoscopic negative pressure therapy

“…When performing this procedure, we follow a treatment algorithm (Fig. 1; [4]), which has also been adopted by other users [5, 6].

Fig.

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