Endoscopic Vacuum Therapy for Esophageal Leakage

Abstract

The reported incidence of esophageal anastomotic leakages after gastrectomy and esophagectomy ranges from 5% to almost 30%. Within the last 10 years endoscopic treatment has changed the approach to intrathoracic anastomotic leakages. Implantation of completely covered self-expanding metal or plastic stents is the endoscopic method that has been most extensively studied, and it has proven to be effective in 67–100% of cases. The successful closure of intrathoracic anastomotic leaks by endoscopic placement of a vacuum sponge endoscopic vacuum assisted closure (E-VAC) has recently been reported. Vacuum-assisted closure (VAC) is an established treatment modality for extensive cutaneous infected wounds. This principle has been adapted to endoscopically accessible upper gastrointestinal leakages by endoscopically placing sponges that have been connected with a drainage tube in the necrotic cavities (E-VAC). Here, how the technique works and how vacuum sponge therapy rapidly improves intrathoracic necrotic cavities after upper gastrointestinal leakage are demonstrated. This article is part of an expert video encyclopedia.