486. ENDOSCOPIC VACUUM THERAPY FOR ANASTOMOTIC LEAKAGE AFTER ESOPHAGEAL RESECTION—A RETROSPECTIVE SINGLE-CENTER ANALYSIS

Abstract

Abstract Esophagectomy still comes with a high rate of anastomotic leakage resulting in a persisting high postoperative mortality. Endoscopic vacuum therapy (EVT) is an upcoming technique for the treatment of anastomotic leakages. We aimed to evaluate our experience with the efficacy of EVT for anastomotic leakages after esophagectomy for cancer. We retrospectively analyzed all 96 patients who had undergone Ivor-Lewis resection for esophageal malignancy from January 2015 until December 2021 for the need of EVT within the same hospital stay. Patients demographics, perioperative parameters, treatment efficacy and success were analyzed. Patient data were expressed as mean ± standard deviation. We included fourteen patients treated with EVT following Ivor-Lewis resection for esophageal malignancy within the same hospital stay. 12 EVTs were due to anastomotic leakage whereas two procedures were performed prophylactically. We started the EVT 10.71 ± 8.04 days after surgery with a mean duration of 13.86 ± 7.39 days and a mean number of 4.36 ± 2.37 endoscopies per patient. Successful treatment was achieved in 10 patients (71.4%), one patient needed an esophageal stenting and an additional surgery for re-anastomosis was needed in 3 patients (21.4%). EVT can prevent re-operation in a high proportion of patients with anastomotic leakage and therefore provides a good non-surgical option for these patients. The periinterventional risk and possible complications of repetitive endoscopies should be analyzed in larger studies.