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Results of Endoscopic Vacuum-assisted closure Device for treatment of Upper GI Leaks

Marc Bludau, PD, Dr, med1, Hf Fuchs, MD1, S Brinkmann1, Cj Bruns1, Ah Hölscher2, Jm Leers1, W Schröder1, Sh Chon1. 1University Hospital Cologne, 2Markus Hospital Frankfurt

Introduction: Esophageal perforations and postoperative leakage of esophagogastrostomy are considered to be life-threatening conditions due to the development of mediastinitis and consecutive sepsis. Vacuum-assisted closure (VAC), a well-established treatment method for superficial infected wounds, is based on a negative pressure applied to the wound via a vacuum-sealed sponge. Endoluminal VAC (E-VAC) therapy is a novel method, and experience with its esophageal application is limited.

In this presentation the experience of a high volume center with endoluminal VAC therapy in patients with leaks of the upper GI tract is summarized.

Patients: Between october 2010 and September 2016 45 patients with esophageal defects were treated using the endoluminal VAC application. 6 patients had a spontaneous, 12 patients an iatrogenic and 27 patients a postoperative esophageal defect.

Complete restoration of the esophageal defect was achieved in 36 of 45 patients. The average duration of application was 4,08 days, and an average of 3,94 E-VAC systems were used. For 14 of the 45 patients, E-VAC therapy was combined with the placement of self-expanding metal stents.

Conclusion: This study demonstrates that E-VAC therapy adds an additional treatment option for esophageal wall defects. Esophageal defects and mediastinal absesses can be treated with endoluminal VAC Therapie, where endoscopic stenting is not possible.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 80931

Program Number: S072

Presentation Session: Flexible / Therapeutic Endoscopy and NOTES

Presentation Type: Podium

47

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