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Comparison of Endoscopic Vacuum Therapy Versus Stent for Anastomotic Leak After Esophagectomy

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Endoscopic vacuum therapy is a novel option for the management of esophageal leaks. This study compares endoscopic vacuum therapy versus placement of covered stents for anastomotic leaks after esophagectomy.

Methods

N = 45 consecutive patients with anastomotic leaks following esophagectomy (including patients referred to our center from other hospitals for complication management) were managed by endoscopic therapy at our institution from January 2009 to February 2015. Outcomes of stent and endoscopic vacuum therapy were analyzed retrospectively.

Results

Thirty patients received endoscopic stent placement and 15 endoscopic vacuum therapy. In the stent group, seven patients were switched to endoscopic vacuum and four to surgery. Classified by type of initial endoscopic therapy, the success rate (anastomotic healing, patient recovered) was higher for endoscopic vacuum therapy (endoscopic vacuum 93.3 %, stent 63.3 %; p = 0.038). Classified by final endoscopic therapy (after switches in therapy), success rates were 86.4 and 60.9 % (p = 0.091), respectively. There was no difference observed in mortality, duration of therapy, and length of hospital stay between the study groups.

Conclusions

Endoscopic vacuum therapy might be more effective than endoscopic stent placement in the management of esophageal anastomotic leaks.

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Acknowledgments

We would like to thank all the nurses of our surgical endoscopy department for the expert technical assistance.

We thank Dr. Philipp Doebler, Institute for Psychology, University of Muenster, Germany, for the statistical consultation.

Conflict of Interest

Dr. Laukoetter is a member of the expert panel of negative pressure wound therapy of the Paul Hartmann AG company. He received fees for invited speeches on endoscopic vacuum therapy.

All other authors declare that they have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of General and Visceral Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Geb. W1, D-48149, Muenster, Germany

    Rudolf Mennigen, Carolin Harting, Kirsten Lindner, Thorsten Vowinkel, Emile Rijcken, Daniel Palmes, Norbert Senninger & Mike G. Laukoetter

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  1. Rudolf Mennigen
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  2. Carolin Harting
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  3. Kirsten Lindner
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  4. Thorsten Vowinkel
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  5. Emile Rijcken
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  6. Daniel Palmes
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  7. Norbert Senninger
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  8. Mike G. Laukoetter
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Correspondence to Rudolf Mennigen.

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Mennigen, R., Harting, C., Lindner, K. et al. Comparison of Endoscopic Vacuum Therapy Versus Stent for Anastomotic Leak After Esophagectomy. J Gastrointest Surg 19, 1229–1235 (2015). https://doi.org/10.1007/s11605-015-2847-7

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  • DOI: https://doi.org/10.1007/s11605-015-2847-7

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