Teresa Bernadette Steinbichler, Dolores Wolfram, Annette Runge, Roland Hartl, Daniel Dejaco, Tina Rauchenwald, Claus Pototschnig, Herbert Riechelmann, Volker Hans Schartinger
BACKGROUND: Pharyngocutaneous fistula is a potential life-threatening complication following head and neck surgery. There is only limited evidence about the efficacy of vacuum-assisted closure (VAC) therapy and endoscopic vacuum-assisted closure (EndoVAC) therapy for the treatment of pharyngocutaneous fistulas. METHODS: In this article, we report on a consecutive case series of six male patients with pharyngocutaneous fistula treated with a modified outside-in EndoVAC technique...
April 8, 2021: Head & Neck
Seung-Hun Chon, Eleonora Ramadori, Daniel Pinto Dos Santos, Florian Lorenz, Hakan Alakus, Tobias Goeser, Christiane Josephine Bruns
No abstract text is available yet for this article.
March 15, 2021: Endoscopy
Rami Archid, Fateh Bazerbachi, Barham K Abu Dayyeh, Felix Hönes, Suhaib J S Ahmad, Karolin Thiel, Giorgi Nadiradze, Alfred Königsrainer, Dörte Wichmann
PURPOSE: Staple line leak (SLL) is a serious complication after sleeve gastrectomy (SG). Common endoscopic treatment options include self-expandable metallic stent (SEMS), endoscopic internal drainage (EID), and endoscopic closure. The endoscopic negative pressure therapy (ENPT) is a promising treatment option combining temporary sealing of the defect with drainage of the inflammatory bed. In this study, we compare the outcome of ENPT and SEMS for the treatment of SLL following SG. MATERIALS AND METHODS: A retrospective cohort of 27 patients (21 females) treated at a single center for SLL after SG was included...
March 1, 2021: Obesity Surgery
Mateusz Jagielski, Jacek Piątkowski, Grzegorz Jarczyk, Marek Jackowski
BACKGROUND: Surgery is the gold standard for the treatment of malignant tumors of the rectum. Intestinal anastomotic leakage remains a serious complication of colorectal surgery. The efficacy and safety of transrectal endoscopic drainage by vacuum therapy in patients with intestinal anastomotic leakage after surgical treatment of middle and distal rectal tumors were assessed. METHODS: Prospective analysis of treatment outcomes among patients undergoing surgery for middle and distal rectal tumors at the Department of General, Gastroenterological, and Oncological Surgery of the Ludwik Rydygier Collegium Medicum in Bydgoszcz and Nicolaus Copernicus University in Torun from 2016 to 2019 was conducted...
March 1, 2021: Surgical Endoscopy
Ann-Kathrin Eichelmann, Sarah Ismail, Jennifer Merten, Patrycja Slepecka, Daniel Palmes, Mike G Laukötter, Andreas Pascher, Wolf Arif Mardin
BACKGROUND: Endoscopic vacuum therapy (EVT) has become a promising option in the management of anastomotic leakage (AL) after esophagectomy. However, EVT is an effortful approach associated with multiple interventions. In this study, we conduct a comparative cost analysis for methods of management of AL. METHODS: All patients who experienced AL treated by EVT, stent, or reoperation following Ivor Lewis esophagectomy for esophageal cancer were included. Cases that were managed by more than one modality were excluded...
February 24, 2021: Journal of Gastrointestinal Surgery
Chengcheng Christine Zhang, Lukas Liesenfeld, Rosa Klotz, Ronald Koschny, Christian Rupp, Thomas Schmidt, Markus K Diener, Beat P Müller-Stich, Thilo Hackert, Peter Sauer, Markus W Büchler, Anja Schaible
BACKGROUND: Anastomotic leakage (AL) in the upper gastrointestinal (GI) tract is associated with high morbidity and mortality rates. Especially intrathoracic anastomotic leakage leads to life-threatening complications. Endoscopic vacuum therapy (EVT) for anastomotic leakage after transthoracic esophageal resection represents a novel concept. However, sound clinical data are still scarce. This retrospective, single-center study aimed to evaluate the feasibility, effectiveness, and safety of EVT for intrathoracic anastomotic leakage following abdomino-thoracic esophageal resection...
February 16, 2021: BMC Gastroenterology
Savni Satoskar, Sarang Kashyap, Francisco Benavides, Robert Jones, Richard Angelico, Vinay Singhal
INTRODUCTION: Endoscopic vacuum (endovac) therapy has shown excellent outcomes when used for esophageal anastomotic leaks. The results of endovac therapy are superior to those of other endoscopic therapies for esophageal leaks. CASE PRESENTATION: We present a case of a 70-year-old male with esophageal adenocarcinoma who underwent Ivor Lewis esophagogastrectomy that was complicated by an esophageal leak. After failure of multiple endoscopic therapies (i.e. stents and clips), he responded well to endovac therapy...
November 20, 2020: International Journal of Surgery Case Reports
Carlo Jung, Rachel Hallit, Annegret Müller-Dornieden, Melanie Calmels, Diane Goere, Ulriikka Chaput, Marine Camus, Jean-Michel Gonzalez, Marc Barthet, Jeremie Jacques, Romain Legros, Thierry Barrioz, Fabian Kück, Ali Seif Amir Hosseini, Micheal Ghadimi, Steffen Kunsch, Volker Ellenrieder, Edris Wedi, Maximilien Barret
BACKGROUND: Endoscopic internal drainage (EID) with double pigtail stents and low negative pressure endoscopic vacuum therapy (EVT) are treatment options for leakages after upper GI oncologic surgery. We aimed to compare the effectiveness of these techniques. PATIENTS AND METHODS: Between 2016 and 2019, patients treated with EID in five centers in France and with EVT in Göttingen, Germany were included and retrospectively analyzed using univariate analysis. Pigtails were changed every 4 weeks, EVT was repeated every 3-4 days until leak closure...
January 27, 2021: Endoscopy
Chris-Henrik Wulfert, Christian Theodor Müller, Ahmed Farouk Abdel-Kawi, Wolfgang Schulze, Henning Schmidt-Seithe, Sonko Borstelmann, Gunnar Loske
Objectives: We describe the first application of intrauterine negative-pressure therapy (IU-NPT) for an early rupture of a uterine suture after a third caesarean section with consecutive peritonitis and sepsis. Because all four quadrants were affected by peritonitis, a laparotomy was performed on the 15th day after caesarean section. Abdominal negative-pressure wound therapy (A-NPWT) of the open abdomen was initiated. During the planned relaparotomy, a suture defect of the anterior uterine wall was identified and sutured...
March 2020: Innovative Surgical Sciences
Gary Sharp, Daniel Steffens, Cherry E Koh
BACKGROUND: Anastomotic leak (AL) is a devastating complication. Several new treatment options are available, endoluminal negative pressure therapy is one. The aims of this systematic review are; to report success rates and stoma closure rates following endoluminal negative pressure therapy in colorectal AL patients. METHODS: A systematic review of MEDLINE, PubMed, Cochrane and Embase databases from inception to June 2018. Search limits were; English language, humans, sample >5 and >18 years...
January 22, 2021: ANZ Journal of Surgery
Guilherme Tavares, Francisco Tustumi, Luca Schiliró Tristão, Wanderley Marques Bernardo
The curative treatment for esophageal and gastric cancer is primarily surgical resection. One of the main complications related to esophagogastric surgery is the anastomotic leak. This complication is associated with a prolonged length of stay, reduced quality of life, high treatment costs, and an increased mortality rate. The placement of endoluminal stents is the most frequent endoscopic therapy in these cases. However, since its introduction, endoscopic vacuum therapy has been shown to be a promising alternative in the management of this complication...
January 22, 2021: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Sonia Fernández-Ananín, Eulalia Ballester, Carlos Guarner Argente, Carmen Balague, Eduard M Targarona
No abstract text is available yet for this article.
December 2020: Gastroenterology Report
Masaru Hayami, Fredrik Klevebro, Andrianos Tsekrekos, Johanna Samola Winnberg, Satoshi Kamiya, Ioannis Rouvelas, Magnus Nilsson, Mats Lindblad
Anastomotic leak is a serious complication after esophagectomy. Endoscopic vacuum therapy (EVT) has become increasingly popular in treating upper gastrointestinal anastomotic leaks over the last years. We are here reporting our current complete experience with EVT as primary treatment for anastomotic leak following esophagectomy. This is a retrospective study analyzing all patients with EVT as primary treatment for anastomotic leak after esophagectomy between November 2016 and January 2020 at Karolinska University Hospital, Sweden...
December 24, 2020: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Epifanio Silvino do Monte Junior, Diogo Turiani Hourneaux de Moura, Igor Braga Ribeiro, Kelly Elizabeth Hathorn, Galileu Ferreira Ayala Farias, Carolina Vaz Turiani, Flaubert Sena Medeiros, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura
BACKGROUND: Upper gastrointestinal fistulas, leaks, and perforations represent a high cost burden to health systems worldwide, with high morbidity and mortality rates for affected patients. Management of these transmural defects remains therapeutically challenging. OBJECTIVES: The aim of this study is to perform a systematic review and meta-analysis to investigate the efficacy and safety of self-expanding metal stents (SEMS) versus endoscopic vacuum therapy (EVT) for treatment of upper gastrointestinal transmural defects...
August 16, 2020: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Adam Bobkiewicz, Lukasz Krokowicz, Tomasz Banasiewicz, Maciej Borejsza-Wysocki
Introduction: Anastomotic leaks remain the most fearful complications. Aim: We present a novel endoscopic salvage therapy known as endoscopic vacuum therapy with instillation (iEVT) as a combination of standard endoscopic vacuum therapy (EVT) and negative pressure wound therapy with instillation (iNPWT). Material and methods: A case series of 6 consecutive patients treated with iEVT is presented. A Redon drain and a central venous catheter were introduced within polyurethane foam used as a self- made device for iEVT and antimicrobial solution was instilled...
December 2020: Videosurgery and Other Miniinvasive Techniques
Flaubert Sena de Medeiros, Epifanio Silvino do Monte Junior, Romero de Lima França, Heli Clóvis de Medeiros Neto, Juliany Medeiros Santos, Eligio Alves Almeida Júnior, Samuel Oliveira da Silva Júnior, Mario Herman Santos Moura Pedreira Tavares, Eduardo Guimarães Hourneaux de Moura
BACKGROUND: Pancreaticoduodenectomy is a technically demanding operation, with reported morbidity rates of approximately 40%-50%. A novel idea is to use endoscopic vacuum therapy (EVT) in a preemptive setting to prevent anastomotic leakage and pancreatic fistulas. In a recent case series, EVT was proven to be effective in preventing leaks in patients with anastomotic ischemia. There have been no previous reports on preemptive EVT after pancreaticoduodenectomy. CASE SUMMARY: We describe the case of a 71-year-old woman with hypertension and diabetes who was admitted to the emergency room with jaundice, choluria, fecal acholia, abdominal pain, and fever...
November 16, 2020: World Journal of Gastrointestinal Endoscopy
Florian Kühn, Ulrich Wirth, Julia Zimmermann, Nicola Beger, Sandro M Hasenhütl, Moritz Drefs, Christian Heiliger, Maria Burian, Jens Werner, Tobias S Schiergens
BACKGROUND: Evidence for endoscopic vacuum therapy (EVT) for colorectal defects is still based on small patient series from various institutions, employing different treatment algorithms and methods. As EVT was invented at our institution 20 years ago, the aim was to report the efficacy and safety of EVT for colorectal defects as well as to analyze factors associated with efficacy, therapy duration, and outpatient treatment. METHODS: Cohort study with analysis of prospectively collected data of patients receiving EVT for colorectal defects at a tertiary referral center in Germany (n = 281)...
December 1, 2020: Surgical Endoscopy
Carlo Alberto De Pasqual, Valentina Mengardo, Francesco Tomba, Alessandro Veltri, Michele Sacco, Simone Giacopuzzi, Jacopo Weindelmayer, Giovanni de Manzoni
The treatment of leak after esophageal and gastric surgery is a major challenge. Over the last few years, endoscopic vacuum therapy (E-VAC) has gained popularity in the management of this life-threatening complication. We reported our initial experience on E-VAC therapy as rescue treatment in refractory anastomotic leak and perforation after gastro-esophageal surgery. From September 2017 to December 2019, a total of 8 E-VAC therapies were placed as secondary treatment in 7 patients. Six for anastomotic leak (3 cervical, 1 thoracic, 2 abdominal) and 1 for perforation of the gastric conduit...
November 30, 2020: Updates in Surgery
T Haruštiak, J Tvrdoň, A Pazdro, M Šnajdauf, H Faltová, T Teršíp, J Wolesky, V Černý, J Schützner, A Stolz, P Pafko, R Lischke
INTRODUCTION: Anastomotic leak (AL) is one of the most serious surgical complications after esophagectomy. Endoscopic, radiological and surgical methods are used in the treatment of AL. The aim of this study was to retrospectively evaluate our therapeutic procedures and results of AL treatment after Ivor Lewis esophagectomy (ILE). METHODS: Retrospective audit of all ILEs performed in the years 20052019. Evaluation of AL treatment results according to Esophagectomy Complication Consensus Group (ECCG) classification and according to the primary therapeutic procedure with a focus on the treatment with esophageal stent...
2020: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Sarah Durbin, Jose Luis Aranez, Mazen Shobassy, Robert Jay Sealock
No abstract text is available yet for this article.
November 2020: VideoGIE
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