Endoscopic vacuum assisted closure of esophagogastric anastomosis dehiscence: A case report.
Anastomotic insufficiency
Case report
Endoscopic negative pressure wound therapy
Endoscopic vacuum assisted closure
Esophagogastric leakage
Journal
World journal of gastrointestinal endoscopy
ISSN: 1948-5190
Titre abrégé: World J Gastrointest Endosc
Pays: United States
ID NLM: 101532474
Informations de publication
Date de publication:
16 Jan 2020
16 Jan 2020
Historique:
received:
08
05
2019
revised:
19
09
2019
accepted:
06
11
2019
entrez:
17
1
2020
pubmed:
17
1
2020
medline:
17
1
2020
Statut:
ppublish
Résumé
Esophagogastric leakage is one of the most severe postoperative complications. Partial disruption of the anastomosis, can be successfully treated with an endoscopic vacuum assisted closure (E-VAC). The advantage of that method of treatment is the ability to adjust a vacuum dressing individually to the size of the dehiscence and thus to reduce the risk of a secondary fistula or abscess. The authors present two patients with postoperative gastroesophageal leakage treated successfully with E-VAC. Two male patients developed a potentially life threatening esophagogastric leakage. Patient A underwent resection of the distal half of the esophagus and upper part of the stomach due to Siewert type II adenocarcinoma of the gastroesophageal junction. Proximal resection of the stomach was performed in the patient B after massive bleeding from Mallory-Weiss tears. Both patients were treated successfully with an individually adapted E-VAC with concomitant correction of fluid and electrolyte disturbances, and treatment of sepsis with appropriate antibiotics. Endoscopic vacuum closure is an effective alternative to endoscopic stenting or relaparotomy. Through individual approach it allows a more accurate assessment of healing.
Sections du résumé
BACKGROUND
BACKGROUND
Esophagogastric leakage is one of the most severe postoperative complications. Partial disruption of the anastomosis, can be successfully treated with an endoscopic vacuum assisted closure (E-VAC). The advantage of that method of treatment is the ability to adjust a vacuum dressing individually to the size of the dehiscence and thus to reduce the risk of a secondary fistula or abscess. The authors present two patients with postoperative gastroesophageal leakage treated successfully with E-VAC.
CASE SUMMARY
METHODS
Two male patients developed a potentially life threatening esophagogastric leakage. Patient A underwent resection of the distal half of the esophagus and upper part of the stomach due to Siewert type II adenocarcinoma of the gastroesophageal junction. Proximal resection of the stomach was performed in the patient B after massive bleeding from Mallory-Weiss tears. Both patients were treated successfully with an individually adapted E-VAC with concomitant correction of fluid and electrolyte disturbances, and treatment of sepsis with appropriate antibiotics.
CONCLUSION
CONCLUSIONS
Endoscopic vacuum closure is an effective alternative to endoscopic stenting or relaparotomy. Through individual approach it allows a more accurate assessment of healing.
Identifiants
pubmed: 31942233
doi: 10.4253/wjge.v12.i1.42
pmc: PMC6939118
doi:
Types de publication
Case Reports
Langues
eng
Pagination
42-48Informations de copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: Authors declare no conflict of interest regarding this manuscript.
Références
Dig Surg. 2019;36(4):309-316
pubmed: 29870974
J Gastrointest Surg. 2019 Feb;23(2):280-287
pubmed: 30430432
Wideochir Inne Tech Maloinwazyjne. 2015 Jul;10(2):299-310
pubmed: 26240633
Endoscopy. 2017 May;49(5):498-503
pubmed: 28107761
Surg Endosc. 2017 Feb;31(2):612-617
pubmed: 27317034
Ann Surg. 2015 Aug;262(2):286-94
pubmed: 25607756
Am J Surg. 1992 May;163(5):484-9
pubmed: 1575303
Ann Med Surg (Lond). 2016 Jan 04;5:118-24
pubmed: 27222711
Medicine (Baltimore). 2016 Apr;95(16):e3416
pubmed: 27100431
Gastrointest Endosc. 2010 Feb;71(2):382-6
pubmed: 19879566
Dis Esophagus. 2017 Dec 1;30(12):1-10
pubmed: 28881894
Gastroenterol Res Pract. 2018 Apr 4;2018:1697968
pubmed: 29849581
Cir Esp. 2015 Nov;93(9):549-51
pubmed: 26549879