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Endoscopic vacuum therapy for treatment of spontaneous and iatrogenic upper gastrointestinal defects
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Kavea Panneerselvam, Jake S. Jacob, Ronald E. Samuel, Andy Tau, Gyanprakash A. Ketwaroo, Wasif M. Abidi, Robert J. Sealock
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Clin Endosc 2023;56(6):754-760. Published online May 9, 2023
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DOI: https://doi.org/10.5946/ce.2022.177
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 - Background
/Aims: Endoscopic vacuum therapy (EVT) can heal a variety of defects within the gastrointestinal (GI) tract via applying negative pressure, which reduces the defect size, aspirates the infected fluid, and promotes granulation tissue. Here we present our experience with EVT as it relates to both spontaneous and iatrogenic upper GI tract perforations, leaks, and fistulas.
Methods
This retrospective study was conducted at four large hospital centers. All patients who underwent EVT between June 2018 and March 2021 were included. Data on multiple variables were collected, including demographics, defect size and location, number and intervals of EVT exchanges, technical success, and hospital length of stay. Student t-test and the chi-squared test were used to analyze the data.
Results
Twenty patients underwent EVT. The most common defect cause was spontaneous esophageal perforation (50%). The most common defect location was the distal esophagus (55%). The success rate was 80%. Seven patients were treated with EVT as the primary closure method. The mean number of exchanges was five with a mean interval of 4.3 days between exchanges. The mean length of hospital stay was 55.8 days.
Conclusions
EVT is a safe and effective initial management option for esophageal leaks and perforations.
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Citations
Citations to this article as recorded by  - Endoscopic vacuum therapy: management of upper gastrointestinal anastomotic leaks and esophageal perforations
María de Armas Conde, Carmen Díaz-López , Vanessa Concepción-Martín, María Del Pilar Borque-Barrera
Revista Española de Enfermedades Digestivas.2024;[Epub] CrossRef - Management of fistulas in the upper gastrointestinal tract
Maria Valeria Matteo, Maria Mihaela Birligea, Vincenzo Bove, Valerio Pontecorvi, Martina De Siena, Loredana Gualtieri, Federico Barbaro, Cristiano Spada, Ivo Boškoski
Best Practice & Research Clinical Gastroenterology.2024; 70: 101929. CrossRef - Endoscopic Vacuum Therapy of Upper Gastrointestinal Anastomotic Leaks: How to Deal with the Challenges (with Video)
Laurent Monino, Tom G. Moreels
Life.2023; 13(6): 1412. CrossRef
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