Management of major postsurgical gastroesophageal intrathoracic leaks with an endoscopic vacuum-assisted closure system

Wedemeyer, Jochen; Brangewitz, M; Kubicka, Stefan; Jackobs, Steffan; Winkler, Michael; Neipp, Michael; Klempnauer, Jürgen; Manns, Michael P.; Schneider, Andrea

doi:10.1016/j.gie.2009.07.011

Cited by 90 publications

(58 citation statements)

References 24 publications

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“…7) Qadder et al introduced an endoscopic clipping method for esophageal perforations. 8) They reported that the endoclip was a useful method for treating both acute and chronic esophageal perforation. 9) In 2007, Rolf et al first introduced the E-VAC system to treat a patient with anastomotic leakage after an anterior resection of the rectum.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Vacuum-Assisted Closure (E-VAC) Treatment in a Patient with Delayed Anastomotic Perforation following a Perforated Gastric Conduit Repair after an Ivor-Lewis Esophagectomy

Youn

Kwon

2016

ATCS

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It has been reported that intrathoracic esophageal leakages occur at a rate of 4%-17% after Ivor-Lewis esophagectomy. There has been no consensus on a specific treatment for the post-operative anastomotic leakage. Recently, endoscopic vacuum-assisted closure (E-VAC) has been introduced as a novel treatment for the post-operative anastomotic leakage. We herein report the case of a patient with early perforation of the gastric conduit followed by late esophagogastric anastomotic leakage who was successfully treated with early surgical repair and subsequent E-VAC. The patient had been previously diagnosed with achalasia and squamous cell carcinoma of the esophagus and undergone an Ivor-Lewis esophagectomy.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Vacuum-Assisted Closure (E-VAC) Treatment in a Patient with Delayed Anastomotic Perforation following a Perforated Gastric Conduit Repair after an Ivor-Lewis Esophagectomy

Youn

Kwon

2016

ATCS

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“…The same group later reported successful closure of major intrathoracic post-surgical leak in 7 of 8 patients (88%) after a median of 23 days and 7 endoscopies without major complications. 102 Similarly, Ahrens et al 97 reported E-VAC assisted closure of gastroesophageal leak in all 5 patients at a median 42 days and 9 procedures, 2 of them developed stenosis requiring endoscopic dilation. Recent study suggests E-VAC therapy may be superior to stent placement for management of esophageal leaks.…”

Section: Endoscopic Vacuum Assisted Closure Devicementioning

confidence: 92%

Endoscopic management of postoperative fistulas and leaks

Devaraj

Gavini

2017

Int J Gastrointest Interv

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Postoperative complications from gastrointestinal surgery can be associated with significant morbidity, and mortality especially if repeat surgery is needed to address these complications. There are wide array of endoscopic interventions and tools available for management of these complications using minimally invasive methods thus decreasing length of hospitalization, morbidity and leading to better patient outcomes. With the advent new tools like Overstitch device, Over the Scope Clip, fibrin glue, etc., these complications can be managed successfully with minimal morbidity. We provide an indepth discussion about available endoscopic options and their application in various scenarios in our article. Endoscopist should be familiar with these complications and endoscopic tools to promote use of these tools and techniques to achieve successful management of these complex conditions.

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“…Alternative zur Behandlung von thorakalen Anastomoseninsuffizienzen dar [24,25,26,27,28]. Der vakuumassistierte Verschluss (Vacuum-Assisted Closure, V.A.C.)…”

Section: Endoskopische Vakuumschwammtherapieunclassified

“…Insgesamt resultiert dies in einer beschleunigten Wundheilung. Dieses Grundprinzip konnte zunächst erfolgreich für die Behandlung von Rektuminsuffizienzen etabliert werden (Endo-Sponge®; B. Braun Aesculap, Tuttlingen, Deutschland) [32] und in der Folge dann für Leckagen im oberen Gastrointestinaltrakt [24,25,26,27,28]. Hierfür wird ein Schwamm, in den eine Drainage eingenäht ist, endoskopisch in die Insuffizienzhöhle transportiert (fig.…”

Section: Endoskopische Vakuumschwammtherapieunclassified

Endoskopische Therapie von Nahtinsuffizienzen des Ösophagus

Wedemeyer

2012

Visc Med

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Hintergrund: Nahtinsuffizienzen stellen eine gefürchtete Komplikation nach Operationen an der Speiseröhre dar, die mit hoher Morbidität und Mortalität vergesellschaftet sind. Methoden: Die Einlage komplett beschichteter Stents stellt die am häufigsten eingesetzte Methode zur Behandlung ösophagealer Leckagen dar. Eine neue endoskopische Therapiemodalität besteht mit der endoskopischen Vakuumschwammtherapie. Hierbei macht man sich die positiven Effekte des vakuumassistierten Verschlusses (Vacuum-Assisted Closure, V.A.C.), der eine etablierte Therapiemodalität zur Behandlung ausgedehnter infizierter Hautdefekte darstellt, zunutze. Durch neue Entwicklungen haben auch Clips (insbesondere der «Over-the-Scope-Clip», OTSC) wieder eine Bedeutung beim Verschluss von ösophagealen Nahtinsuffizienzen erhalten. Ergebnisse: Mit diesen endoskopischen Techniken lassen sich Nahtinsuffizienzen des Ösophagus in über 80% der Fälle erfolgreich verschließen. Schlussfolgerung: Endoskopische Techniken stellen eine geeignete Methode zum Verschluss ösophagealer Leckagen dar und konnten daher in den letzten 10 Jahren die chirurgische Revision weitestgehend verdrängen

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Management of major postsurgical gastroesophageal intrathoracic leaks with an endoscopic vacuum-assisted closure system

Cited by 90 publications

References 24 publications

Endoscopic Vacuum-Assisted Closure (E-VAC) Treatment in a Patient with Delayed Anastomotic Perforation following a Perforated Gastric Conduit Repair after an Ivor-Lewis Esophagectomy

Endoscopic Vacuum-Assisted Closure (E-VAC) Treatment in a Patient with Delayed Anastomotic Perforation following a Perforated Gastric Conduit Repair after an Ivor-Lewis Esophagectomy

Endoscopic management of postoperative fistulas and leaks

Endoskopische Therapie von Nahtinsuffizienzen des Ösophagus

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