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Endoluminal VAC

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16 papers 0 to 25 followers
By Alejandro Peñarrieta Daher Residente de Cirugía Pediatrica en Hospital Infantil de México Federico Gómez
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)...
June 2017: Surgical Endoscopy
Steven G Leeds, James S Burdick, James W Fleshman
No abstract text is available yet for this article.
June 1, 2016: JAMA 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
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
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
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
Alberto Arezzo, Mauro Verra, Roberto Passera, Alberto Bullano, Lisa Rapetti, Mario Morino
BACKGROUND: Anastomotic leaks are a severe complication after colorectal surgery. We aimed to evaluate the long-term efficacy of endoscopic vacuum therapy for their treatment. METHODS: Retrospective review of a series of post-surgical colorectal leaks treated with endoscopic vacuum therapy, with minimum follow-up of 1 year. Generalized peritonitis or haemodynamic instability was considered contraindication to endoscopic treatment. RESULTS: Endoscopic vacuum therapy was applied in 14 patients with colorectal leak, in 2 cases complicated by recto-vaginal fistula...
April 2015: Digestive and Liver Disease
Nils Heits, Leonie Stapel, Benedikt Reichert, Clemens Schafmayer, Bodo Schniewind, Thomas Becker, Jochen Hampe, Jan-Hendrik Egberts
BACKGROUND: Esophageal perforation is a serious disease with a high morbidity and mortality rate. Endoscopic vacuum therapy (EVT) is a new endoscopic treatment option, which is used to treat anastomotic leakages after rectal and esophageal resections. We report on 10 patients treated with EVT for esophageal perforation. METHODS: Clinical and therapy-related data such as age, sex, duration of intensive care stay, length of hospital stay, reasons for perforation, EVT-associated complications, mortality, need for alternative treatment options, and course of infectious variables were analyzed...
March 2014: Annals of Thoracic Surgery
M Bludau, A H Hölscher, T Herbold, J M Leers, C Gutschow, H Fuchs, W Schröder
BACKGROUND: Esophageal perforations and postoperative leakage of esophagogastrostomy are considered to be life-threatening conditions due to the development of mediastinitis and consecutive sepsis. Vacuum-assisted closure (VAC), a well-established treatment method for superficial infected wounds, is based on a negative pressure applied to the wound via a vacuum-sealed sponge. Endoluminal VAC (E-VAC) therapy is a novel method, and experience with its esophageal application is limited. METHODS: This retrospective study summarizes the experience of a center with a high volume of upper gastrointestinal surgery using E-VAC therapy for patients with leakages of the esophagus...
March 2014: Surgical Endoscopy
M Brangewitz, T Voigtländer, F A Helfritz, T O Lankisch, M Winkler, J Klempnauer, M P Manns, A S Schneider, J Wedemeyer
BACKGROUND AND STUDY AIM: Placement of covered self-expanding metal or plastic stents (SEMS or SEPS) is an established method for managing intrathoracic leaks. Recently, endoscopic vacuum-assisted closure (EVAC) has been described as a new effective treatment option. Our aim was to compare stent placement with EVAC for nonsurgical closure of intrathoracic anastomotic leaks. PATIENTS AND METHODS: In a retrospective analysis we were able to identify 39 patients who were treated with SEMS or SEPS and 32 patients who were treated with EVAC for intrathoracic leakage...
June 2013: Endoscopy
Bodo Schniewind, Clemens Schafmayer, Gesa Voehrs, Jan Egberts, Witigo von Schoenfels, Tobias Rose, Roland Kurdow, Alexander Arlt, Mark Ellrichmann, Christian Jürgensen, Stefan Schreiber, Thomas Becker, Jochen Hampe
BACKGROUND: Anastomotic leakage after esophagectomy is a life-threatening complication. No comparative outcome analyses for the different treatment regimens are yet available. METHODS: In a single-center study, data from all esophagectomy patients from January 1995 to January 2012, including tumor characteristics, surgical procedure, postoperative anastomotic leakage, leakage therapy regimens, APACHE II scores, and mortality, were collected, and predictors of patient survival after anastomotic leakage were analyzed...
October 2013: Surgical Endoscopy
F Kuehn, L Schiffmann, B M Rau, E Klar
INTRODUCTION: Emergency operations for perforations and anastomotic leakage of the upper gastrointestinal tract are associated with a high overall morbidity and mortality rate. An endoscopic vacuum therapy (EVT) has been established successfully for anastomotic leakage after rectal resection but only limited data exist for EVT of the upper GI tract. METHODS: We report on a series of nine patients treated with EVT for defects of the upper intestinal tract between March 2011 and May 2012...
November 2012: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Rolf Weidenhagen, Wolfgang H Hartl, Klaus U Gruetzner, Martin E Eichhorn, Fritz Spelsberg, Karl W Jauch
BACKGROUND: Anastomotic leakage after esophagectomy is an important determinant of early and late morbidity and mortality. Control of the septic focus is essential when treating patients with anastomotic leakages. Surgical and endoscopic treatment options are limited. METHODS: Between 2005 and 2009, we treated 6 patients who experienced an intrathoracic anastomotic leakage after esophageal resection. After all established therapeutic measures had failed, we explored the feasibility of an endoscopically assisted mediastinal vacuum therapy...
November 2010: Annals of Thoracic Surgery
Jochen Wedemeyer, Mira Brangewitz, Stefan Kubicka, Steffan Jackobs, Michael Winkler, Michael Neipp, Jürgen Klempnauer, Michael P Manns, Andrea S Schneider
BACKGROUND: Endoscopic treatment options for postsurgical intrathoracic leaks include injection of fibrin glue, clip application, and stent placement. Endoscopic vacuum-assisted closure (E-VAC) may be an effective treatment option. OBJECTIVE: To demonstrate that E-VAC is an effective endoscopic treatment option for closure of major intrathoracic postsurgical leaks. DESIGN AND SETTING: A prospective, single-center study at an academic medical center...
February 2010: Gastrointestinal Endoscopy
Wolfram von Bernstorff, Anne Glitsch, André Schreiber, Lars Ivo Partecke, Claus Dieter Heidecke
PURPOSE: The purpose of the study was to prospectively assess the impact of neoadjuvant radiochemotherapy on the formation of major anastomotic rectal leaks and treatment by endoscopic transanal vacuum-assisted rectal drainage (ETVARD). MATERIALS AND METHODS: Twenty six patients with malignancies with rectal anastomotic leaks were prospectively treated, including 14 of 26 patients following neoadjuvant radiochemotherapy. ETVARD was the first-line treatment. RESULTS: In 23 of 26 patients, ETVARD was successfully completed...
July 2009: International Journal of Colorectal Disease
Jochen Wedemeyer, Andrea Schneider, Michael P Manns, Steffan Jackobs
BACKGROUND: Management of intrathoracic anastomotic leaks remains an interdisciplinary challenge. Established treatment options include percutaneous drainage, endoscopic closure, or even surgical revision. All these procedures are associated with high morbidity and mortality rates. OBJECTIVE: We report a new, effective endoscopic treatment option for intrathoracic esophageal anastomotic leaks by using an endoscopic vacuum-assisted closure system. PATIENTS: Two patients with intrathoracic anastomotic leaks after esophagectomy and gastrectomy were included...
April 2008: Gastrointestinal Endoscopy
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