Abstract
Esophageal fistula is a rare disease with a mortality rate of up to 31% of cases and with multifactorial causes. The most common etiologies of esophageal perforation are associated with iatrogenic, foreign body ingestion, as well as cases of lesions of neoplastic origin. Consisting of an innovative therapy with efficiency not yet evaluated in clinical studies, the present study sought to report a series of cases of patients with esophageal fistulas undergoing treatment with endoscopic vacuum therapy (VTE) assisted by the service team of a tertiary public hospital. from the state of Ceará in order to contribute with evidence that reinforces the role of VTE in the closure of esophageal perforations of different etiologies. In addition, in order to contextualize the importance of the cases presented, we carried out an integrative review in order to list the main clinical findings on the use of VTE available in the world scientific literature. There was a need for continuous development of new clinical studies that seek to improve and validate the use of VTE for the safe and effective treatment of esophageal fistulas, emphasizing that treatment with VTE can maximize the therapeutic response, bringing a greater and better clinical patient satisfaction.
Highlights
Esophageal perforation or fistula is a rare, potentially fatal problem, with a mortality rate of up to 31% of cases and with multifactorial causes
Consisting of an innovative therapy with efficiency not yet evaluated in clinical studies, the present study sought to report a series of cases of patients with esophageal fistulas undergoing treatment with endoscopic vacuum therapy assisted by the service team of a tertiary public hospital in the state of Ceará in order to contribute with evidence that reinforces the role of VTE in the closure of esophageal perforations of different etiologies
Based on the data obtained in this study, it was possible to conclude that there is a significant number of case reports that demonstrate the impact of the occurrence of esophageal fistulas treated with endoscopic vacuum therapy associated with different clinical occurrences, such as Boerhaave Syndrome, carcinomas and dehiscence of esophagogastric anastomosis
Summary
Esophageal perforation or fistula is a rare, potentially fatal problem, with a mortality rate of up to 31% of cases and with multifactorial causes. VTE consists of a surgical procedure that uses a polyurethane sponge drain positioned in the esophageal lumen or inside the fistulous cavity with its connection connected to a continuous negative pressure vacuum system. It can be performed using a low-cost modified drainage system, using a nasogastric tube with gauze coated with perforated sterile plastic [5]. Consisting of an innovative therapy with efficiency not yet evaluated in clinical studies, the present study sought to report a series of cases of patients with esophageal fistulas undergoing treatment with endoscopic vacuum therapy assisted by the service team of a tertiary public hospital in the state of Ceará in order to contribute with evidence that reinforces the role of VTE in the closure of esophageal perforations of different etiologies. In order to contextualize the importance of the cases presented, we carried out an integrative review in order to list the main clinical findings on the use of VTE available in the world scientific literature
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