Surgery, Gastroenterology and Oncology
Vol. 24, Nr. 3, Jun 2019
Endoscopic Vacuum Therapy for Die-Hard Leaks After Esophagectomy in Multiple Comorbid Esophageal Cancer Patients
Il Hyun Baek, Seong Hwan Kim
Images in Clinical Medicine, Jun 2019
Article DOI: 10.21614/sgo-24-3-152
Postoperative leakage of upper gastrointestinal tract secondary to esophagectomy or gastrectomy is considered a dangerous situation due to the possible occurrence of mediastinitis and following sepsis. We experienced two multiple comorbid cases of luminal wall defect developed after esophageal resection for squamous cell carcinoma of the esophagus.
The patients were treated by jejunostomy and prolonged parenteral nutrition, but the defects persisted. To resolve the defect lesion, we used continuous suction with endoscopically applied a vacuum-sealed size-adjusted polyurethane vacuum system (Endoscopic Vacuum Therapy; EVT).
EVT was performed as an isolated therapy or as a combination therapy with fibrin glue for the acceleration of healing. Without any procedure-related complications, both patients' leaks were resolved. Complete closure was verified by esophagogastroduodenoscopy and upper gastrointestinal tract series.
Endoscopic vacuum assisted closure using a sponge can be an appropriate new therapeutic selection for wall defect after upper gastrointestinal surgery, especially in multiple comorbid patients.

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Surgery, Gastroenterology and Oncology is indexed in Scopus, CrossRef (DOI: 10.21614/sgo)

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