Universität zu Köln

Bludau, Marc ORCID: 0000-0002-0338-1545, Fuchs, Hans F., Herbold, Till, Maus, Martin K. H., Alakus, Hakan, Popp, Felix, Leers, Jessica M., Bruns, Christiane J., Hoelscher, Arnulf H., Schroeder, Wolfgang and Chon, Seung-Hun ORCID: 0000-0002-8923-6428 (2018). Results of endoscopic vacuum-assisted closure device for treatment of upper GI leaks. Surg. Endosc., 32 (4). S. 1906 - 1915. NEW YORK: SPRINGER. ISSN 1432-2218

Full text not available from this repository.

Abstract

Esophageal perforations and postoperative leakage of esophagogastrostomies are considered to be life-threatening conditions due to the potential development of mediastinitis and consecutive sepsis. Vacuum-assisted closure (VAC) techniques, a well-established treatment method for superficial infected wounds, are based on a negative pressure applied to the wound via a vacuum-sealed sponge. Endoluminal VAC (E-VAC) therapy as a treatment for GI leakages in the rectum was introduced in 2008. E-VAC therapy is a novel method, and experience regarding esophageal applications is limited. In this retrospective study, the experience of a high-volume center for upper GI surgery with E-VAC therapy in patients with leaks of the upper GI tract is summarized. To our knowledge, this series presents the largest patient cohort worldwide in a single-center study. Between October 2010 and January 2017, 77 patients with defects in the upper gastrointestinal tract were treated using the E-VAC application. Six patients had a spontaneous perforation, 12 patients an iatrogenic injury, and 59 patients a postoperative leakage in the upper gastrointestinal tract. Complete restoration of the esophageal defect was achieved in 60 of 77 patients. The average duration of application was 11.0 days, and a median of 2.75 E-VAC systems were used. For 21 of the 77 patients, E-VAC therapy was combined with the placement of self-expanding metal stents. This study demonstrates that E-VAC therapy provides an additional treatment option for esophageal wall defects. Esophageal defects and mediastinal abscesses can be treated with E-VAC therapy where endoscopic stenting may not be possible. A prospective multi-center study has to be directed to bring evidence to the superiority of E-VAC therapy for patients suffering from upper GI defects.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bludau, Marc UNSPECIFIED orcid.org/0000-0002-0338-1545 UNSPECIFIED Fuchs, Hans F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Herbold, Till UNSPECIFIED UNSPECIFIED UNSPECIFIED Maus, Martin K. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Alakus, Hakan UNSPECIFIED UNSPECIFIED UNSPECIFIED Popp, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Leers, Jessica M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Chon, Seung-Hun UNSPECIFIED orcid.org/0000-0002-8923-6428 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-191959
DOI:	10.1007/s00464-017-5883-4
Journal or Publication Title:	Surg. Endosc.
Volume:	32
Number:	4
Page Range:	S. 1906 - 1915
Date:	2018
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-2218
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ESOPHAGEAL-PERFORATION; RETROSPECTIVE ANALYSIS; ANASTOMOTIC LEAKAGE; TREATMENT OPTIONS; THERAPY; MANAGEMENT; STENT Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19195