Endoscopic vacuum therapy for treatment of spontaneous and iatrogenic upper gastrointestinal defects
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Background/Aims: Endoscopic vacuum therapy (EVT) can heal a variety of defects within the gastrointestinal (GI) tract via applyingnegative pressure, which reduces the defect size, aspirates the infected fluid, and promotes granulation tissue. Here we present our ex-perience 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 2018and March 2021 were included. Data on multiple variables were collected, including demographics, defect size and location, numberand intervals of EVT exchanges, technical success, and hospital length of stay. Student t-test and the chi-squared test were used to ana-lyze the data. Results: Twenty patients underwent EVT. The most common defect cause was spontaneous esophageal perforation (50%). The mostcommon defect location was the distal esophagus (55%). The success rate was 80%. Seven patients were treated with EVT as the prima-ry closure method. The mean number of exchanges was five with a mean interval of 4.3 days between exchanges. The mean length ofhospital stay was 55.8 days. Conclusions: EVT is a safe and effective initial management option for esophageal leaks and perforations.
Abstract
Background/Aims: Endoscopic vacuum therapy (EVT) can heal a variety of defects within the gastrointestinal (GI) tract via applyingnegative pressure, which reduces the defect size, aspirates the infected fluid, and promotes granulation tissue. Here we present our ex-perience 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 2018and March 2021 were included. Data on multiple variables were collected, including demographics, defect size and location, numberand intervals of EVT exchanges, technical success, and hospital length of stay. Student t-test and the chi-squared test were used to ana-lyze the data. Results: Twenty patients underwent EVT. The most common defect cause was spontaneous esophageal perforation (50%). The mostcommon defect location was the distal esophagus (55%). The success rate was 80%. Seven patients were treated with EVT as the prima-ry closure method. The mean number of exchanges was five with a mean interval of 4.3 days between exchanges. The mean length ofhospital stay was 55.8 days. Conclusions: EVT is a safe and effective initial management option for esophageal leaks and perforations.
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