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Endoscopic vacuum therapy

Geraldine Ooi, Paul Burton, Andrew Packiyanathan, Damien Loh, Richard Chen, Kalai Shaw, Wendy Brown, Peter Nottle
BACKGROUND: Endoscopic vacuum-assisted closure (EndoVAC) therapy is a recent innovation described for use in upper gastrointestinal perforations and leaks, with reported success of 80-90%. It provides sepsis control and collapses the cavity preventing stasis, encouraging healing of the defect. Whilst promising, initial reports of this new technique have not established clear indications, feasibility and optimal technique. METHODS: We analysed all patients who underwent EndoVAC therapy between 2014 and 2016...
November 15, 2016: ANZ Journal of Surgery
K Krajinovic, S Reimer, T Kudlich, C T Germer, A Wiegering
BACKGROUND: Anastomotic leakage (AL) is one of the most common and serious complications following visceral surgery. In recent years, endoluminal vacuum therapy has dramatically changed therapeutic options for AL, but its use has been limited to areas easily accessible by endoscope. CASE PRESENTATION: We describe the first use of endoluminal vacuum therapy in the small intestine employing a combined surgical and endoscopic "rendezvous technique" in which the surgeon assists the endoscopic placement of an endoluminal vacuum therapy sponge in the jejunum by means of a pullback string...
December 2016: Surgical Case Reports
Mike G Laukoetter, Rudolf Mennigen, Philipp A Neumann, Sameer Dhayat, Gabriele Horst, Daniel Palmes, Norbert Senninger, Thorsten Vowinkel
BACKGROUND: Perforations and anastomotic leakages of the upper gastrointestinal (GI) tract cause a high morbidity and mortality rate. Only limited data exist for endoscopic vacuum therapy (EVT) in the upper GI tract. METHODS: Fifty-two patients (37 men and 15 women, ages 41-94 years) were treated (12/2011-12/2015) with EVT for anastomotic insufficiency secondary to esophagectomy or gastrectomy (n = 39), iatrogenic esophageal perforation (n = 9) and Boerhaave syndrome (n = 4)...
October 5, 2016: Surgical Endoscopy
Gunnar Loske, Tobias Schorsch, Christian T Müller
No abstract text is available yet for this article.
August 8, 2016: Deutsches Ärzteblatt International
Edwin Halliday, Anant Patel, Andrew Hindmarsh, Vijay Sujendran
Endoscopic vacuum-assisted closure (VAC) is increasingly being used as a means of managing perforations or anastomotic leaks of the upper gastrointestinal (GI) tract. Published outcomes are favourable, with few mentions of complications or morbidity. We present a case in which the management of a gastric perforation with endoscopic vacuum therapy was complicated by cervical oesophageal perforation. The case highlights the risks of such endoscopic therapeutic procedures and is the first report in the literature to describe significant visceral injury during placement of a VAC device for upper GI perforation...
July 28, 2016: Journal of Surgical Case Reports
G Loske, T Schorsch
INTRODUCTION: Operative and interventional treatment of Boerhaave's syndrome include closure of the esophageal defect and drainage of the septic focus. Initial reports on the use of endoscopic vacuum therapy (EVT) of Boerhaave's syndrome are now available. This article describes the experiences gained from the clinical application in two patients using this new surgical endoscopic procedure. The current literature regarding treatment of Boerhaave's syndrome is presented. MATERIAL AND METHODS: Open-pore drainage is endoscopically placed either through the transmural defect in the extraluminal wound cavity (intracavitary EVT) or overlapping the defect into the esophageal lumen (intraluminal EVT)...
August 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Steven G Leeds, James S Burdick
BACKGROUND: Sleeve gastrectomy has become a popular weight loss procedure, but it is associated with staple line leak resulting in high morbidity and mortality. Current management options range from endoscopic techniques (predominantly stent placement) to surgical intervention. OBJECTIVE: The purpose of this study was to recognize endoluminal vacuum (E-Vac) therapy as a viable option for use in anastomotic leaks of sleeve gastrectomies. SETTING: This study took place at Baylor University Medical Center at Dallas, Texas...
January 21, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Gunnar Loske, Josef Aumiller, Frank Rucktäschel, Tobias Schorsch
No abstract text is available yet for this article.
2016: Endoscopy
Gunnar Loske, Tobias Schorsch, Olaf Gobrecht, Eckhard Martens, Frank Rucktäschel
No abstract text is available yet for this article.
2016: Endoscopy
Jae J Hwang, Yeon S Jeong, Young S Park, Hyuk Yoon, Cheol M Shin, Nayoung Kim, Dong H Lee
The aim of the present study was to evaluate the more effective therapy for the postsurgical gastroesophageal leakage by a head-to-head comparison of endoscopic vacuum therapy (EVT) and endoscopic stent implantation with self-expandable metal stent (E-SEMS). In this hospital-based, retrospective, observative study, the patients were classified into 2 groups. Those treated with EVT were assigned to the EVT group (n = 7), and those treated with E-SMS were assigned to the E-SEMS group (n = 11). We evaluated the clinical characteristics and treatment outcomes between the 2 groups...
April 2016: Medicine (Baltimore)
X W Wu, J A Ren, J S Li
Intestinal fistulas are severe complications after abdominal surgical procedures. The endoscopic therapy makes it possible to close fistulas without surgical interventions. When patients achieved stabilization and had no signs of systemic sepsis or inflammation, these therapies could be conducted, which included endoscopic vacuum therapy, fibrin glue sealing, stents, fistula plug, suture, and Over The Scope Clip (OTSC). Various techniques may be combined. Endoscopy vacuum therapy could be applied to control systemic inflammation and prevent continuing septic contamination by active drainage...
March 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Oliver Möschler, Christoph Nies, Michael K Mueller
BACKGROUND AND STUDY AIMS: Injuries to the esophageal wall, such as perforations and anastomotic leaks, are serious complications of surgical and endoscopic interventions. Since 2006, a new treatment has been introduced, in the form of endoscopically placed vacuum sponge therapy. PATIENTS AND METHODS: Between April 2012 and October 2014, 10 patients (5 men and 5 women) aged 57 to 94 years were treated at our institution using endoscopic vacuum therapy (EVT) in the upper gastrointestinal tract...
December 2015: Endoscopy International Open
Gunnar Loske, Tobias Schorsch, Christian Dahm, Eckhard Martens, Christian Müller
BACKGROUND AND STUDY AIMS: Endoscopic Vacuum Therapy (EVT) has been reported as a novel treatment option for esophageal leakage. We present our results in the treatment of iatrogenic perforation with EVT in a case series of 10 patients. PATIENTS AND METHODS: An open pore polyurethane drainage was placed either intracavitary through the perforation defect or intraluminal covering the defect zone. Application of vacuum suction with an electronic device (continuous negative pressure, -125 mmHg) resulted in defect closure and internal drainage...
December 2015: Endoscopy International Open
Gunnar Loske, Frank Rucktäschel, Tobias Schorsch, Vera van Ackeren, Bettina Stark, Christian T Müller
No abstract text is available yet for this article.
January 2015: Endoscopy
Florian Kuehn, Leif Schiffmann, Florian Janisch, Frank Schwandner, Guido Alsfasser, Michael Gock, Ernst Klar
INTRODUCTION: Intraluminal therapy used in the gastrointestinal (GI) tract was first shown for anastomotic leaks after rectal resection. Since a few years vacuum sponge therapy is increasingly being recognized as a new promising method for repairing upper GI defects of different etiology. The principles of vacuum-assisted closure (VAC) therapy remain the same no matter of localization: Continuous or intermittent suction and drainage decrease bacterial contamination, secretion, and local edema...
February 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Torben Glatz, Andreas Fischer, Jens Hoeppner, Robert Thimme, Christine Walker, Hans-Jürgen Richter-Schrag
No abstract text is available yet for this article.
2015: Endoscopy
Florian Kuehn, Florian Janisch, Frank Schwandner, Guido Alsfasser, Leif Schiffmann, Michael Gock, Ernst Klar
INTRODUCTION: Endoscopic vacuum therapy (EVT) has been established in Germany for the treatment of anastomotic leakage after rectal resection. Continuous or intermittent suction and drainage decrease bacterial contamination, secretion, and local edema promoting perfusion and granulation at the same time. However, data for use and long-term results of EVT in colorectal surgery are still scarce and are often limited by short-term follow-up. OBJECTIVES: Here, we aimed at analyzing the treatment spectrum and long-term outcome of EVT for defects of the lower gastrointestinal tract...
February 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Metin Keskin, Onur Bayram, Türker Bulut, Emre Balik
Anastomotic leakage is a serious complication with significant morbidity and mortality. The popularity of endoscopic treatment (Endo-SPONGE) is increasing for distally located colorectal pouch-anal anastomotic leakages. This was a retrospective study of 15 cases involving the application of the Endo-SPONGE for anastomotic leakage following proctectomy between May 2009 and May 2014. Of the 15 cases, lower anterior resection occurred in 12 cases (80%), and pouch-anal anastomosis in 3 cases (18%). In 8 patients (55%), the endosponge was applied during the early term, and in 7 patients (45%) during the late term...
December 2015: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Nathan R Smallwood, James W Fleshman, Steven G Leeds, J S Burdick
INTRODUCTION: Upper intestinal leaks and perforations are associated with high morbidity and mortality rates. Despite the growing experience using endoscopically placed stents, the treatment of these leaks and perforations remain a challenge. Endoluminal vacuum (E-Vac) therapy is a novel treatment that has been successfully used in Germany to treat upper gastrointestinal leaks and perforations. There currently are no reports on its use in the USA. METHODS: E-Vac therapy was used to treat 11 patients with upper gastrointestinal leaks and perforations from September 2013 to September 2014...
June 2016: Surgical Endoscopy
F Benedix, S F Dalicho, B Garlipp, H Ptok, J Arend, C Bruns
BACKGROUND: Surgical resection of tumors of the upper gastrointestinal (GI) tract represent complex procedures and are still associated with a relevant morbidity and mortality. A targeted preoperative risk analysis and patient selection with consideration of the nutritional status and comorbidities are important in order to reduce the perioperative complication rate. RESULTS AND DISCUSSION: Anastomotic leaks still remain the most feared surgical complication and in addition to early recognition, immediate initiation of an appropriate therapy are essential...
November 2015: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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