Efficacy of endoscopic vacuum therapy in esophageal luminal defects: a systematic review and meta-analysis
Background/Aims Endoscopic vacuum-assisted closure (EVAC) is a novel technique used to repair esophageal perforation and leaks. Varying data have been reported on the overall success rate of EVAC. We aimed to conduct a meta-analysis of the available data on the clinical success rate of EVAC. Methods...
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2025-01-01
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| Series: | Clinical Endoscopy |
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| Online Access: | http://www.e-ce.org/upload/pdf/ce-2023-282.pdf |
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| author | Ishaan Vohra Harishankar Gopakumar Neil R. Sharma Srinivas R. Puli |
| author_facet | Ishaan Vohra Harishankar Gopakumar Neil R. Sharma Srinivas R. Puli |
| author_sort | Ishaan Vohra |
| collection | DOAJ |
| description | Background/Aims Endoscopic vacuum-assisted closure (EVAC) is a novel technique used to repair esophageal perforation and leaks. Varying data have been reported on the overall success rate of EVAC. We aimed to conduct a meta-analysis of the available data on the clinical success rate of EVAC. Methods Electronic databases were searched for publications addressing the efficacy of EVAC in esophageal luminal defects. Pooling was conducted using both fixed and random-effects models. The overall clinical success of EVAC therapy was considered the primary outcome, whereas, overall complication rates, need for adjunct therapy, and mortality were considered secondary outcomes. Results In total, 366 patients were included in the study. On pooled analysis, the mean age was 66 years with 68.32% of patients being men. Overall pooled clinical success rate of EVAC therapy was 87.95%. Upon subgroup analysis, the pooled clinical success rate of postsurgical anastomotic leak and transmural esophageal perforation were found to be 86.57% and 88.89%, respectively. The all-cause hospital mortality was 14% and 4.2% in patients with esophageal perforation and EVAC, respectively. Conclusions This study demonstrates that EVAC therapy has a high overall clinical success rate, with low mortality. EVAC therapy seems to be a promising procedure with excellent outcomes in patients with luminal esophageal defects. |
| format | Article |
| id | doaj-art-7ba9a3ab5ecf4403bfc9519c502cc288 |
| institution | Kabale University |
| issn | 2234-2400 2234-2443 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj-art-7ba9a3ab5ecf4403bfc9519c502cc2882025-02-03T08:08:03ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432025-01-01581536210.5946/ce.2023.2827888Efficacy of endoscopic vacuum therapy in esophageal luminal defects: a systematic review and meta-analysisIshaan Vohra0Harishankar Gopakumar1Neil R. Sharma2Srinivas R. Puli3 Department of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, Peoria, IL, USA Department of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, Peoria, IL, USA Parkview Cancer Institute, Advanced Interventional Endoscopy & Endoscopic Oncology (IOSE) Division, GI Oncology Program, Fort Wayne, IN, USA Department of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, Peoria, IL, USABackground/Aims Endoscopic vacuum-assisted closure (EVAC) is a novel technique used to repair esophageal perforation and leaks. Varying data have been reported on the overall success rate of EVAC. We aimed to conduct a meta-analysis of the available data on the clinical success rate of EVAC. Methods Electronic databases were searched for publications addressing the efficacy of EVAC in esophageal luminal defects. Pooling was conducted using both fixed and random-effects models. The overall clinical success of EVAC therapy was considered the primary outcome, whereas, overall complication rates, need for adjunct therapy, and mortality were considered secondary outcomes. Results In total, 366 patients were included in the study. On pooled analysis, the mean age was 66 years with 68.32% of patients being men. Overall pooled clinical success rate of EVAC therapy was 87.95%. Upon subgroup analysis, the pooled clinical success rate of postsurgical anastomotic leak and transmural esophageal perforation were found to be 86.57% and 88.89%, respectively. The all-cause hospital mortality was 14% and 4.2% in patients with esophageal perforation and EVAC, respectively. Conclusions This study demonstrates that EVAC therapy has a high overall clinical success rate, with low mortality. EVAC therapy seems to be a promising procedure with excellent outcomes in patients with luminal esophageal defects.http://www.e-ce.org/upload/pdf/ce-2023-282.pdfendoscopyesophagusmeta-analysisperforation |
| spellingShingle | Ishaan Vohra Harishankar Gopakumar Neil R. Sharma Srinivas R. Puli Efficacy of endoscopic vacuum therapy in esophageal luminal defects: a systematic review and meta-analysis Clinical Endoscopy endoscopy esophagus meta-analysis perforation |
| title | Efficacy of endoscopic vacuum therapy in esophageal luminal defects: a systematic review and meta-analysis |
| title_full | Efficacy of endoscopic vacuum therapy in esophageal luminal defects: a systematic review and meta-analysis |
| title_fullStr | Efficacy of endoscopic vacuum therapy in esophageal luminal defects: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy of endoscopic vacuum therapy in esophageal luminal defects: a systematic review and meta-analysis |
| title_short | Efficacy of endoscopic vacuum therapy in esophageal luminal defects: a systematic review and meta-analysis |
| title_sort | efficacy of endoscopic vacuum therapy in esophageal luminal defects a systematic review and meta analysis |
| topic | endoscopy esophagus meta-analysis perforation |
| url | http://www.e-ce.org/upload/pdf/ce-2023-282.pdf |
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