Use of endoscopic vacuum (E-Vac) therapy for the treatment of a cervical oesophagoileostomy leakage after a right-colon interposition for oesophageal replacement.

Abstract

Anastomotic leakage is considered the Achilles heel after oesophagogastric resection and its therapeutic management remains a challenge. Different endoscopic options, such a clips, stents, internal drainage, fibrin glue instillation, or suturing devices, have been suggested as minimally endoscopic therapies to treat these complications. Recently, the use of endoscopic vacuum (E-Vac) therapy has proven to be useful for the healing of these adverse events and some studies have even reported its superiority to other endoscopic devices [1]. The E-Vac promotes the growth of granulation tissue and increases microcirculation while providing debridement of the cavity leak in each sponge replacement by continuous negative pressure. We describe an exceptional clinical scenario in which the use of the E-Vac allows the successful closure of a cervical oesophagoileostomy leakage and the resolution of a mediastinal abscess after an ileum and right-colon interposition for oesophageal replacement.