Intraluminal continuous decompression and drainage using a vacuum pump for controlling cervical anastomotic leakage after a three-field esophagectomy with a gastric pull-up

Abstract

Anastomotic leakage is one of the major complications that can occur after an esophagectomy. We report on the advantages of a computer-controlled portable vacuum pump system, Thopaz®, for intraluminal continuous decompression and drainage in the non-surgical management of cervical anastomotic leakage. Continuous decompression with negative pressure of 20 cm H2O was set at the anastomotic leakage point by a naso-gastric tube or a trans-gastric decompression tube. The drainage effect was confirmed by swallowing contrast media under fluoroscopy. Three successive cases with postoperative anastomotic leakage received this treatment. The treatments were successful without complication and the leakages were healed 7, 15, and 17 days after the treatments, respectively. The management of anastomotic leakage using the portable pump system was beneficial in bringing about a prompt healing with minimum intervention. To further demonstrate the advantage of this procedure over conventional treatments, a larger data set and clinical trials are required.