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Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience

AIM: To study the efficacy of E-VAC therapy for patients with anastomotic leakage after esophagectomy. METHODS: Between January 2013 and April 2017, 12 patients underwent E-VAC therapy for the management of postoperative leakage. Their clinical features and endoscopic procedure details, therapy resu...

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Autores principales: Noh, Soo Min, Ahn, Ji Yong, Lee, Jeong Hoon, Jung, Hwoon-Yong, AlGhamdi, Zeead, Kim, Hyeong Ryul, Kim, Yong-Hee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5904779/
https://www.ncbi.nlm.nih.gov/pubmed/29849581
http://dx.doi.org/10.1155/2018/1697968
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author Noh, Soo Min
Ahn, Ji Yong
Lee, Jeong Hoon
Jung, Hwoon-Yong
AlGhamdi, Zeead
Kim, Hyeong Ryul
Kim, Yong-Hee
author_facet Noh, Soo Min
Ahn, Ji Yong
Lee, Jeong Hoon
Jung, Hwoon-Yong
AlGhamdi, Zeead
Kim, Hyeong Ryul
Kim, Yong-Hee
author_sort Noh, Soo Min
collection PubMed
description AIM: To study the efficacy of E-VAC therapy for patients with anastomotic leakage after esophagectomy. METHODS: Between January 2013 and April 2017, 12 patients underwent E-VAC therapy for the management of postoperative leakage. Their clinical features and endoscopic procedure details, therapy results, adverse events, and survival were investigated. RESULTS: All 12 patients were male and the median age was 57 years (interquartile range 51.5–62.8 years). The reasons for esophageal surgery were esophageal cancer (83.3%), gastrointestinal stromal tumor (8.3%), and esophageal diverticulum (8.3%). Prior to E-VAC therapy, 6 patients had undergone failed primary surgical repair and the median duration from esophagectomy to leakage discovery was 13.5 days (IQR 6–207 days). The median duration of E-VAC therapy was 25 days (IQR 13.5–34.8 days) and the average sponge exchange rate was 2.7 times during the treatment period. After E-VAC therapy, 8 patients (66.7%) had complete leakage closure, 3 (25%) had a decreased leakage size, and 1 (8.3%) was unchanged. The three patients with a decreased leakage size after E-VAC therapy were treated with endoscopic and conservative management without further surgery. CONCLUSION: With proper patient selection, E-VAC therapy is a feasible and safe method for the treatment of anastomotic leakage after esophagectomy.
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spelling pubmed-59047792018-05-30 Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience Noh, Soo Min Ahn, Ji Yong Lee, Jeong Hoon Jung, Hwoon-Yong AlGhamdi, Zeead Kim, Hyeong Ryul Kim, Yong-Hee Gastroenterol Res Pract Research Article AIM: To study the efficacy of E-VAC therapy for patients with anastomotic leakage after esophagectomy. METHODS: Between January 2013 and April 2017, 12 patients underwent E-VAC therapy for the management of postoperative leakage. Their clinical features and endoscopic procedure details, therapy results, adverse events, and survival were investigated. RESULTS: All 12 patients were male and the median age was 57 years (interquartile range 51.5–62.8 years). The reasons for esophageal surgery were esophageal cancer (83.3%), gastrointestinal stromal tumor (8.3%), and esophageal diverticulum (8.3%). Prior to E-VAC therapy, 6 patients had undergone failed primary surgical repair and the median duration from esophagectomy to leakage discovery was 13.5 days (IQR 6–207 days). The median duration of E-VAC therapy was 25 days (IQR 13.5–34.8 days) and the average sponge exchange rate was 2.7 times during the treatment period. After E-VAC therapy, 8 patients (66.7%) had complete leakage closure, 3 (25%) had a decreased leakage size, and 1 (8.3%) was unchanged. The three patients with a decreased leakage size after E-VAC therapy were treated with endoscopic and conservative management without further surgery. CONCLUSION: With proper patient selection, E-VAC therapy is a feasible and safe method for the treatment of anastomotic leakage after esophagectomy. Hindawi 2018-04-04 /pmc/articles/PMC5904779/ /pubmed/29849581 http://dx.doi.org/10.1155/2018/1697968 Text en Copyright © 2018 Soo Min Noh et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Noh, Soo Min
Ahn, Ji Yong
Lee, Jeong Hoon
Jung, Hwoon-Yong
AlGhamdi, Zeead
Kim, Hyeong Ryul
Kim, Yong-Hee
Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience
title Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience
title_full Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience
title_fullStr Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience
title_full_unstemmed Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience
title_short Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience
title_sort endoscopic vacuum-assisted closure therapy in patients with anastomotic leakage after esophagectomy: a single-center experience
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5904779/
https://www.ncbi.nlm.nih.gov/pubmed/29849581
http://dx.doi.org/10.1155/2018/1697968
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