Universität zu Köln

Bludau, M., Hoelscher, A. H., Herbold, T., Leers, J. M., Gutschow, C., Fuchs, H. and Schroeder, W. (2014). Management of upper intestinal leaks using an endoscopic vacuum-assisted closure system (E-VAC). Surg. Endosc., 28 (3). S. 896 - 902. NEW YORK: SPRINGER. ISSN 1432-2218

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Abstract

Esophageal perforations and postoperative leakage of esophagogastrostomy are considered to be life-threatening conditions due to the development of mediastinitis and consecutive sepsis. Vacuum-assisted closure (VAC), a well-established treatment method for superficial infected wounds, is based on a negative pressure applied to the wound via a vacuum-sealed sponge. Endoluminal VAC (E-VAC) therapy is a novel method, and experience with its esophageal application is limited. This retrospective study summarizes the experience of a center with a high volume of upper gastrointestinal surgery using E-VAC therapy for patients with leakages of the esophagus. The study investigated 14 patients who had esophageal defects treated with E-VAC. Three patients had a spontaneous defect; two patients had an iatrogenic defect; and nine patients had a postoperative esophageal defect. The average duration of application was 12.1 days, and an average of 3.9 E-VAC systems were used. For 6 of the 14 patients, E-VAC therapy was combined with the placement of self-expanding metal stents. Complete restoration of the esophageal defect was achieved in 12 (86 %) of the 14 patients. Two patients died due to prolonged sepsis. This report demonstrates that E-VAC therapy adds an additional treatment option for partial esophageal wall defects. The combination of E-VAC treatment and endoscopic stenting is a successful novel procedure for achieving a high closure rate.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bludau, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, A. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Herbold, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leers, J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gutschow, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-445570
DOI:	10.1007/s00464-013-3244-5
Journal or Publication Title:	Surg. Endosc.
Volume:	28
Number:	3
Page Range:	S. 896 - 902
Date:	2014
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; ANASTOMOTIC LEAKAGE; RESECTION; THERAPY; OPTIONS Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44557