Universität zu Köln

Chon, Seung-Hun ORCID: 0000-0002-8923-6428, Brunner, Stefanie, Mueller, Dolores T., Lorenz, Florian, Stier, Raphael, Streller, Lea, Eckhoff, Jennifer, Straatman, Jennifer, Babic, Benjamin, Schiffmann, Lars M., Schroeder, Wolfgang, Schmidt, Thomas, Bruns, Christiane J. and Fuchs, Hans F. . Time to endoscopic vacuum therapy-lessons learned after > 150 robotic-assisted minimally invasive esophagectomies (RAMIE) at a German high-volume center. Surg. Endosc.. NEW YORK: SPRINGER. ISSN 1432-2218

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Abstract

Objective of the study In esophageal surgery, anastomotic leak (AL) remains one of the most severe and critical adverse events after oncological esophagectomy. Endoscopic vacuum therapy (EVT) can be used to treat AL; however, in the current literature, treatment outcomes and reports on how to use this novel technique are scarce. The aim of this study was to evaluate the outcomes of patients with an AL after IL RAMIE and to determine whether using EVT as an treatment option is safe and feasible. Material and methods This study includes all patients who developed an Esophagectomy Complications Consensus Group (ECCG) type II AL after IL RAMIE at our center between April 2017 and December 2021. The analysis focuses on time to EVT, duration of EVT, and follow up treatments for these patients. Results A total of 157 patients underwent an IL RAMIE at our hospital. 21 patients of these (13.4%) developed an ECCG type II AL. One patient died of unrelated Covid-19 pneumonia and was excluded from the study cohort. The mean duration of EVT was 12 days (range 4-28 days), with a mean of two sponge changes (range 0-5 changes). AL was diagnosed at a mean of 8 days post-surgery (range 2-16 days). Closure of the AL with EVT was successful in 15 out of 20 patients (75%). Placement of a SEMS (Self-expandlable metallic stent) after EVT was performed in four patients due to persisting AL. Overall success rate of anastomotic sealing independently of the treatment modality was achieved in 19 out of 20 Patients (95%). No severe EVT-related adverse events occurred. Conclusion This study shows that EVT can be a safe and effective endoscopic treatment option for ECCG type II AL.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Chon, Seung-Hun UNSPECIFIED orcid.org/0000-0002-8923-6428 UNSPECIFIED Brunner, Stefanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Dolores T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lorenz, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Stier, Raphael UNSPECIFIED UNSPECIFIED UNSPECIFIED Streller, Lea UNSPECIFIED UNSPECIFIED UNSPECIFIED Eckhoff, Jennifer UNSPECIFIED UNSPECIFIED UNSPECIFIED Straatman, Jennifer UNSPECIFIED UNSPECIFIED UNSPECIFIED Babic, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Schiffmann, Lars M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Hans F. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-657918
DOI:	10.1007/s00464-022-09754-1
Journal or Publication Title:	Surg. Endosc.
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-2218
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRANSTHORACIC ESOPHAGECTOMY; ANASTOMOTIC LEAKAGE; CLOSURE; MANAGEMENT; SUPERIOR; SURGERY Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/65791