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Endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort study

Background  Endoscopic vacuum therapy (EVT) is a novel treatment for esophageal perforations. This study aimed to describe initial experience with EVT of esophageal perforations due to iatrogenic cause, Boerhaave syndrome, or other perforations not related to prior upper gastrointestinal surgery. Me...

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Autores principales: Luttikhold, Joanna, Pattynama, Lisanne M. D., Seewald, Stefan, Groth, Stefan, Morell, Bernhard K., Gutschow, Christian A., Ida, Satoshi, Nilsson, Magnus, Eshuis, Wietse J., Pouw, Roos E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2023
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10465237/
https://www.ncbi.nlm.nih.gov/pubmed/36828030
http://dx.doi.org/10.1055/a-2042-6707
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author Luttikhold, Joanna
Pattynama, Lisanne M. D.
Seewald, Stefan
Groth, Stefan
Morell, Bernhard K.
Gutschow, Christian A.
Ida, Satoshi
Nilsson, Magnus
Eshuis, Wietse J.
Pouw, Roos E.
author_facet Luttikhold, Joanna
Pattynama, Lisanne M. D.
Seewald, Stefan
Groth, Stefan
Morell, Bernhard K.
Gutschow, Christian A.
Ida, Satoshi
Nilsson, Magnus
Eshuis, Wietse J.
Pouw, Roos E.
author_sort Luttikhold, Joanna
collection PubMed
description Background  Endoscopic vacuum therapy (EVT) is a novel treatment for esophageal perforations. This study aimed to describe initial experience with EVT of esophageal perforations due to iatrogenic cause, Boerhaave syndrome, or other perforations not related to prior upper gastrointestinal surgery. Methods  Data from patients treated with EVT for esophageal perforation at five hospitals in three European countries, between January 2018 and October 2021, were retrospectively collected. The primary end point was successful defect closure by EVT, with or without the use of other endoscopic treatment modalities. Secondary end points included mortality and adverse events. Results  27 patients were included (median age 71 years). The success rate was 89 % (24/27, 95 %CI 77–100). EVT failed in three patients: two deceased during EVT (septic embolic stroke, pulmonary embolism) and one underwent esophagectomy due to a persisting defect. Two adverse events occurred: one iatrogenic defect expansion during sponge exchange and one hemorrhage during sponge removal. Median treatment duration was 12 days (interquartile range [IQR] 6–16) with 1 sponge exchange (IQR 1–3). Conclusion  EVT is a promising organ-preserving treatment for esophageal perforations, with a success rate of 89 %. More experience with the technique and indications will likely improve success rates.
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spelling pubmed-104652372023-08-30 Endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort study Luttikhold, Joanna Pattynama, Lisanne M. D. Seewald, Stefan Groth, Stefan Morell, Bernhard K. Gutschow, Christian A. Ida, Satoshi Nilsson, Magnus Eshuis, Wietse J. Pouw, Roos E. Endoscopy Background  Endoscopic vacuum therapy (EVT) is a novel treatment for esophageal perforations. This study aimed to describe initial experience with EVT of esophageal perforations due to iatrogenic cause, Boerhaave syndrome, or other perforations not related to prior upper gastrointestinal surgery. Methods  Data from patients treated with EVT for esophageal perforation at five hospitals in three European countries, between January 2018 and October 2021, were retrospectively collected. The primary end point was successful defect closure by EVT, with or without the use of other endoscopic treatment modalities. Secondary end points included mortality and adverse events. Results  27 patients were included (median age 71 years). The success rate was 89 % (24/27, 95 %CI 77–100). EVT failed in three patients: two deceased during EVT (septic embolic stroke, pulmonary embolism) and one underwent esophagectomy due to a persisting defect. Two adverse events occurred: one iatrogenic defect expansion during sponge exchange and one hemorrhage during sponge removal. Median treatment duration was 12 days (interquartile range [IQR] 6–16) with 1 sponge exchange (IQR 1–3). Conclusion  EVT is a promising organ-preserving treatment for esophageal perforations, with a success rate of 89 %. More experience with the technique and indications will likely improve success rates. Georg Thieme Verlag KG 2023-04-20 /pmc/articles/PMC10465237/ /pubmed/36828030 http://dx.doi.org/10.1055/a-2042-6707 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Luttikhold, Joanna
Pattynama, Lisanne M. D.
Seewald, Stefan
Groth, Stefan
Morell, Bernhard K.
Gutschow, Christian A.
Ida, Satoshi
Nilsson, Magnus
Eshuis, Wietse J.
Pouw, Roos E.
Endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort study
title Endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort study
title_full Endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort study
title_fullStr Endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort study
title_full_unstemmed Endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort study
title_short Endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort study
title_sort endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10465237/
https://www.ncbi.nlm.nih.gov/pubmed/36828030
http://dx.doi.org/10.1055/a-2042-6707
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