Cargando…

Endoscopic vacuum therapy for anastomotic leakage after upper gastrointestinal surgery

Background  Recently, endoscopic vacuum therapy (EVT) was introduced as treatment for anastomotic leakage after upper gastrointestinal (GI) surgery. The aim of this study was to describe the initial experience with EVT for anastomotic leakage after upper GI surgery in a tertiary referral center. Met...

Descripción completa

Detalles Bibliográficos
Autores principales: Pattynama, Lisanne M. D., Pouw, Roos E., Henegouwen, Mark I. van Berge, Daams, Freek, Gisbertz, Suzanne S., Bergman, Jacques J. G. H. M., Eshuis, Wietse J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2023
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602657/
https://www.ncbi.nlm.nih.gov/pubmed/37253387
http://dx.doi.org/10.1055/a-2102-1691
_version_ 1785126429352001536
author Pattynama, Lisanne M. D.
Pouw, Roos E.
Henegouwen, Mark I. van Berge
Daams, Freek
Gisbertz, Suzanne S.
Bergman, Jacques J. G. H. M.
Eshuis, Wietse J.
author_facet Pattynama, Lisanne M. D.
Pouw, Roos E.
Henegouwen, Mark I. van Berge
Daams, Freek
Gisbertz, Suzanne S.
Bergman, Jacques J. G. H. M.
Eshuis, Wietse J.
author_sort Pattynama, Lisanne M. D.
collection PubMed
description Background  Recently, endoscopic vacuum therapy (EVT) was introduced as treatment for anastomotic leakage after upper gastrointestinal (GI) surgery. The aim of this study was to describe the initial experience with EVT for anastomotic leakage after upper GI surgery in a tertiary referral center. Methods  Patients treated with EVT for anastomotic leakage after upper GI surgery were included retrospectively (January 2018–June 2021) and prospectively (June 2021–October 2021). The primary end point was the EVT success rate. Secondary end points included mortality and adverse events. Results  38 patients were included (31 men; mean age 66 years): 27 had undergone an esophagectomy with gastric conduit reconstruction and 11 a total gastrectomy with esophagojejunal anastomosis. EVT was successful in 28 patients (74 %, 95 %CI 57 %–87 %). In 10 patients, EVT failed: deceased owing to radiation pneumonitis (n = 1), EVT-associated complications (n = 2), and defect closure not achieved (n = 7). Mean duration of successful EVT was 33 days, with a median of six EVT-related endoscopies. Median hospital stay was 45 days. Conclusion  This initial experience with EVT for anastomotic leakage after upper GI surgery demonstrated a success rate of 74 %. EVT is a promising therapy that could prevent further major surgery. More experience with the technique and its indications will likely improve success rates in the future.
format Online
Article
Text
id pubmed-10602657
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Georg Thieme Verlag KG
record_format MEDLINE/PubMed
spelling pubmed-106026572023-10-27 Endoscopic vacuum therapy for anastomotic leakage after upper gastrointestinal surgery Pattynama, Lisanne M. D. Pouw, Roos E. Henegouwen, Mark I. van Berge Daams, Freek Gisbertz, Suzanne S. Bergman, Jacques J. G. H. M. Eshuis, Wietse J. Endoscopy Background  Recently, endoscopic vacuum therapy (EVT) was introduced as treatment for anastomotic leakage after upper gastrointestinal (GI) surgery. The aim of this study was to describe the initial experience with EVT for anastomotic leakage after upper GI surgery in a tertiary referral center. Methods  Patients treated with EVT for anastomotic leakage after upper GI surgery were included retrospectively (January 2018–June 2021) and prospectively (June 2021–October 2021). The primary end point was the EVT success rate. Secondary end points included mortality and adverse events. Results  38 patients were included (31 men; mean age 66 years): 27 had undergone an esophagectomy with gastric conduit reconstruction and 11 a total gastrectomy with esophagojejunal anastomosis. EVT was successful in 28 patients (74 %, 95 %CI 57 %–87 %). In 10 patients, EVT failed: deceased owing to radiation pneumonitis (n = 1), EVT-associated complications (n = 2), and defect closure not achieved (n = 7). Mean duration of successful EVT was 33 days, with a median of six EVT-related endoscopies. Median hospital stay was 45 days. Conclusion  This initial experience with EVT for anastomotic leakage after upper GI surgery demonstrated a success rate of 74 %. EVT is a promising therapy that could prevent further major surgery. More experience with the technique and its indications will likely improve success rates in the future. Georg Thieme Verlag KG 2023-07-17 /pmc/articles/PMC10602657/ /pubmed/37253387 http://dx.doi.org/10.1055/a-2102-1691 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 Pattynama, Lisanne M. D.
Pouw, Roos E.
Henegouwen, Mark I. van Berge
Daams, Freek
Gisbertz, Suzanne S.
Bergman, Jacques J. G. H. M.
Eshuis, Wietse J.
Endoscopic vacuum therapy for anastomotic leakage after upper gastrointestinal surgery
title Endoscopic vacuum therapy for anastomotic leakage after upper gastrointestinal surgery
title_full Endoscopic vacuum therapy for anastomotic leakage after upper gastrointestinal surgery
title_fullStr Endoscopic vacuum therapy for anastomotic leakage after upper gastrointestinal surgery
title_full_unstemmed Endoscopic vacuum therapy for anastomotic leakage after upper gastrointestinal surgery
title_short Endoscopic vacuum therapy for anastomotic leakage after upper gastrointestinal surgery
title_sort endoscopic vacuum therapy for anastomotic leakage after upper gastrointestinal surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602657/
https://www.ncbi.nlm.nih.gov/pubmed/37253387
http://dx.doi.org/10.1055/a-2102-1691
work_keys_str_mv AT pattynamalisannemd endoscopicvacuumtherapyforanastomoticleakageafteruppergastrointestinalsurgery
AT pouwroose endoscopicvacuumtherapyforanastomoticleakageafteruppergastrointestinalsurgery
AT henegouwenmarkivanberge endoscopicvacuumtherapyforanastomoticleakageafteruppergastrointestinalsurgery
AT daamsfreek endoscopicvacuumtherapyforanastomoticleakageafteruppergastrointestinalsurgery
AT gisbertzsuzannes endoscopicvacuumtherapyforanastomoticleakageafteruppergastrointestinalsurgery
AT bergmanjacquesjghm endoscopicvacuumtherapyforanastomoticleakageafteruppergastrointestinalsurgery
AT eshuiswietsej endoscopicvacuumtherapyforanastomoticleakageafteruppergastrointestinalsurgery