Endoscopic vacuum therapy of anastomotic leakage and iatrogenic perforation in the esophagus
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The management of anastomotic leakage and iatrogenic esophageal perforation has shifted over recent decades from aggressive surgery to conservative and, recently, endoscopic therapy alternatives. The authors present their results for endoscopic vacuum therapy used to treat both entities.
In the authors’ institution, 17 cases of anastomotic leakage and 7 cases of iatrogenic perforation due to interventional endoscopy or rigid panendoscopy with either intraluminal or intracavitary endoscopic vacuum therapy were treated.
In 23 of 24 cases, the endoscopic treatment was successful. The median duration of therapy was 11 days (range, 4–46 days). All 7 cases of iatrogenic perforation and 16 of 17 anastomotic leakage cases were cured after a median therapy duration of 5 and 12 days, respectively.
Endoscopic vacuum therapy is applicable for a wide range of esophageal defects. In the authors’ experience, it has seemed to be the best choice for iatrogenic perforations and has been a potent supplement in the management of anastomotic leakages.
KeywordsAnastomotic leakage Anastomosis Perforation Esophageal Esophagus Endoscopy Vacuum therapy Complication
Gunnar Loske and Christian Mueller received honoraria for organizing and performing a workshop dealing with vacuum therapy for anastomotic dehiscence after resections in the upper and lower gastrointestinal tract by BBD Aesculap. Gunnar Loske received a grant from Aesculap AG and Olympus Europa Holding GmbH regarding endoscopic vacuum therapy.
Conflict of interest
Tobias Schorsch has no conflicts of interest or financial ties to disclose.
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