Management of upper intestinal leaks using an endoscopic vacuum-assisted closure system (E-VAC)

• DOI: 10.1007/s00464-013-3244-5
• Publication Date: 2013-10-22T16:24:26Z
• Authors: M. Bludau; A. H. Hölscher; T. Herbold; J. M. Leers; C. Gutschow; H. Fuchs; W. Schröder
• Keywords: Mediastinitis; Negative-pressure wound therapy

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