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

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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:
CreatorsEmailORCIDORCID Put Code
Bludau, MarcUNSPECIFIEDorcid.org/0000-0002-0338-1545UNSPECIFIED
Fuchs, Hans F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herbold, TillUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maus, Martin K. H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alakus, HakanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Popp, FelixUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Leers, Jessica M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bruns, Christiane J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoelscher, Arnulf H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schroeder, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chon, Seung-HunUNSPECIFIEDorcid.org/0000-0002-8923-6428UNSPECIFIED
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:
KeywordsLanguage
ESOPHAGEAL-PERFORATION; RETROSPECTIVE ANALYSIS; ANASTOMOTIC LEAKAGE; TREATMENT OPTIONS; THERAPY; MANAGEMENT; STENTMultiple languages
SurgeryMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/19195

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