BACKGROUND: Endoscopic vacuum therapy is a novel option for the management of esophageal leaks. This study compares endoscopic vacuum therapy versus placement of covered stents for anastomotic leaks after esophagectomy. METHODS: N = 45 consecutive patients with anastomotic leaks following esophagectomy (including patients referred to our center from other hospitals for complication management) were managed by endoscopic therapy at our institution from January 2009 to February 2015. Outcomes of stent and endoscopic vacuum therapy were analyzed retrospectively. RESULTS: Thirty patients received endoscopic stent placement and 15 endoscopic vacuum therapy. In the stent group, seven patients were switched to endoscopic vacuum and four to surgery. Classified by type of initial endoscopic therapy, the success rate (anastomotic healing, patient recovered) was higher for endoscopic vacuum therapy (endoscopic vacuum 93.3%, stent 63.3 %; p = 0.038). Classified by final endoscopic therapy (after switches in therapy), success rates were 86.4 and 60.9% (p = 0.091), respectively. There was no difference observed in mortality, duration of therapy, and length of hospital stay between the study groups. CONCLUSIONS: Endoscopic vacuum therapy might be more effective than endoscopic stent placement in the management of esophageal anastomotic leaks.
BACKGROUND: Endoscopic vacuum therapy is a novel option for the management of esophageal leaks. This study compares endoscopic vacuum therapy versus placement of covered stents for anastomotic leaks after esophagectomy. METHODS: N = 45 consecutive patients with anastomotic leaks following esophagectomy (including patients referred to our center from other hospitals for complication management) were managed by endoscopic therapy at our institution from January 2009 to February 2015. Outcomes of stent and endoscopic vacuum therapy were analyzed retrospectively. RESULTS: Thirty patients received endoscopic stent placement and 15 endoscopic vacuum therapy. In the stent group, seven patients were switched to endoscopic vacuum and four to surgery. Classified by type of initial endoscopic therapy, the success rate (anastomotic healing, patient recovered) was higher for endoscopic vacuum therapy (endoscopic vacuum 93.3%, stent 63.3 %; p = 0.038). Classified by final endoscopic therapy (after switches in therapy), success rates were 86.4 and 60.9% (p = 0.091), respectively. There was no difference observed in mortality, duration of therapy, and length of hospital stay between the study groups. CONCLUSIONS: Endoscopic vacuum therapy might be more effective than endoscopic stent placement in the management of esophageal anastomotic leaks.
Authors: Jochen Wedemeyer; Mira Brangewitz; Stefan Kubicka; Steffan Jackobs; Michael Winkler; Michael Neipp; Jürgen Klempnauer; Michael P Manns; Andrea S Schneider Journal: Gastrointest Endosc Date: 2009-10-30 Impact factor: 9.427
Authors: M Brangewitz; T Voigtländer; F A Helfritz; T O Lankisch; M Winkler; J Klempnauer; M P Manns; A S Schneider; J Wedemeyer Journal: Endoscopy Date: 2013-06-03 Impact factor: 10.093
Authors: Natalie S Blencowe; Sean Strong; Angus G K McNair; Sara T Brookes; Tom Crosby; S Michael Griffin; Jane M Blazeby Journal: Ann Surg Date: 2012-04 Impact factor: 12.969
Authors: Jonathan Loeck; Hans-Jürgen von Lücken; Adrian Münscher; Christian Theodor Müller; Gunnar Loske Journal: Eur Arch Otorhinolaryngol Date: 2021-03-14 Impact factor: 2.503
Authors: Fabian Schmidt; Rudolf Mennigen; Thorsten Vowinkel; Philipp A Neumann; Norbert Senninger; Daniel Palmes; Mike G Laukoetter Journal: Obes Surg Date: 2017-09 Impact factor: 4.129
Authors: Sameer A Dhayat; Rosanna Schacht; Rudolf Mennigen; Daniel Palmes; Thomas Vogel; Thorsten Vowinkel; Norbert Senninger; Mike Georg Laukoetter Journal: J Gastrointest Surg Date: 2018-11-14 Impact factor: 3.452
Authors: Mike G Laukoetter; Rudolf Mennigen; Philipp A Neumann; Sameer Dhayat; Gabriele Horst; Daniel Palmes; Norbert Senninger; Thorsten Vowinkel Journal: Surg Endosc Date: 2016-10-05 Impact factor: 4.584
Authors: Marc Bludau; Hans F Fuchs; Till Herbold; Martin K H Maus; Hakan Alakus; Felix Popp; Jessica M Leers; Christiane J Bruns; Arnulf H Hölscher; Wolfgang Schröder; Seung-Hun Chon Journal: Surg Endosc Date: 2017-12-07 Impact factor: 4.584