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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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/1697968 |
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| author | Soo Min Noh Ji Yong Ahn Jeong Hoon Lee Hwoon-Yong Jung Zeead AlGhamdi Hyeong Ryul Kim Yong-Hee Kim |
| author_facet | Soo Min Noh Ji Yong Ahn Jeong Hoon Lee Hwoon-Yong Jung Zeead AlGhamdi Hyeong Ryul Kim Yong-Hee Kim |
| author_sort | Soo Min Noh |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-c5d55cdf902e45a5aed2d2d5fbebd469 |
| institution | DOAJ |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-c5d55cdf902e45a5aed2d2d5fbebd4692025-08-20T03:22:44ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/16979681697968Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center ExperienceSoo Min Noh0Ji Yong Ahn1Jeong Hoon Lee2Hwoon-Yong Jung3Zeead AlGhamdi4Hyeong Ryul Kim5Yong-Hee Kim6Department of Internal Medicine, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaAim. 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.http://dx.doi.org/10.1155/2018/1697968 |
| spellingShingle | Soo Min Noh Ji Yong Ahn Jeong Hoon Lee Hwoon-Yong Jung Zeead AlGhamdi Hyeong Ryul Kim Yong-Hee Kim Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience Gastroenterology Research and Practice |
| 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 |
| url | http://dx.doi.org/10.1155/2018/1697968 |
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