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Comparison of long-term quality of life outcomes between endoscopic vacuum therapy and other treatments for upper gastrointestinal leaks

  • 2023 SAGES Oral
  • Published:
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Abstract

Background

While endoscopic vacuum assisted closure (EVAC) therapy is a validated treatment for gastrointestinal leaks, its impact on long-term quality of life (QoL) is uncertain. The purpose of this study was to evaluate the impact of successful EVAC management on long-term QoL outcomes.

Methods

An institutional review board approved prospectively maintained database was retrospectively reviewed to identify patients undergoing treatment for gastrointestinal leaks between June 2012 and July 2022. The Short-Form 36 (SF-36) survey was used to assess QoL. Patients were contacted by telephone and sent the survey electronically. QoL outcomes between patients who underwent successful EVAC therapy and those who required conventional treatment (CT) were analyzed and compared.

Results

A total of 44 patients (17 EVAC; 27 CT) completed the survey and were included in our analysis. All included patients had foregut leaks with sleeve gastrectomy being the most common sentinel operation (n = 20). The mean time from the sentinel operation was 3.8 years and 4.8 years for the EVAC and CT groups, respectively. When evaluating long-term QoL, the EVAC group scored higher in all QoL domains when compared to the CT group with physical functioning (87.3 vs 69.3, p = 0.04), role limitations due to physical health (84.1 vs 45.7, p = 0.02), energy/fatigue (60.0 vs 40.9, p = 0.04), and social functioning (86.2 vs 64.1, p = 0.04) reaching statistical significance. Overall, patients who achieved organ preservation via successful EVAC therapy scored higher in all domains with role limitations due to physical health (p = 0.04) being statistically significant. In a multivariable regression analysis, increased age and a history of prior abdominal surgery at the time of the sentinel operation were patient characteristics that negatively impacted QoL outcomes.

Conclusion

Patients with gastrointestinal leaks successfully managed by EVAC therapy have better long-term QoL outcomes when compared to patients undergoing other treatments.

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Author information

Authors and Affiliations

  1. Department of Minimally Invasive Surgery, Baylor University Medical Center, 3417 Gaston Avenue, Suite 965, Dallas, TX, 75246, USA

    Lucas Fair, Marc Ward, Bola Aladegbami & Steven Leeds

  2. Center for Advanced Surgery, Baylor Scott and White Health, Dallas, TX, USA

    Lucas Fair, Marc Ward, Bola Aladegbami & Steven Leeds

  3. Texas A&M College of Medicine, Bryan, TX, USA

    Marc Ward, Meghana Vankina, Bola Aladegbami & Steven Leeds

  4. Research Institute, Baylor Scott and White Health, Dallas, TX, USA

    Lucas Fair, Rashmeen Rana, Titus McGowan & Gerald Ogola

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  1. Lucas Fair
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Contributions

LF, MW, MV, RR, TM, BA, and SL contributed to study conception, study design, and data acquisition. GO performed data analysis and interpretation. LF and SL drafted the original manuscript. All authors provided final approval of the submitted version of the manuscript.

Corresponding author

Correspondence to Steven Leeds.

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Disclosures

Dr. Steven Leeds and Dr. Marc Ward are paid consultants for Boston Scientific. Dr. Lucas Fair, Meghana Vankina, Rashmeen Rana, Titus McGowan, Dr. Gerald Ogola, and Dr. Bola Aladegbami have no conflicts of interest or funding sources to disclose.

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Fair, L., Ward, M., Vankina, M. et al. Comparison of long-term quality of life outcomes between endoscopic vacuum therapy and other treatments for upper gastrointestinal leaks. Surg Endosc 37, 6538–6547 (2023). https://doi.org/10.1007/s00464-023-10181-z

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  • DOI: https://doi.org/10.1007/s00464-023-10181-z

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