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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Georg Thieme Verlag KG
2023
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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 |
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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 |
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