Endoscopic internal drainage and low negative-pressure endoscopic vacuum therapy for anastomotic leaks after oncologic upper gastrointestinal surgery.

Anastomotic Leak / etiology Drainage Esophagectomy Humans Negative-Pressure Wound Therapy Retrospective Studies

Journal

Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166

Informations de publication

Date de publication:
01 2022
Historique:
aheadofprint: 27 01 2021
pubmed: 29 1 2021
medline: 27 1 2022
entrez: 28 1 2021
Statut: ppublish

Résumé

Endoscopic internal drainage (EID) with double-pigtail stents or low negative-pressure endoscopic vacuum therapy (EVT) are treatment options for leakage after upper gastrointestinal oncologic surgery. We aimed to compare the effectiveness of these techniques. 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. Pigtail stents were changed every 4 weeks; EVT was repeated every 3-4 days until leak closure. 35 EID and 27 EVT patients were included, with a median (interquartile range [IQR]) leak size of 0.75 cm (0.5-1.5). Overall treatment success was 100 % (95 % confidence interval [CI] 90 %-100 %) for EID vs. 85.2 % (95 %CI 66.3 %-95.8 %) for EVT ( EID and EVT provide high closure rates for upper gastrointestinal anastomotic leaks. EVT provides a shorter treatment duration, at the cost of a higher number of procedures.

Sections du résumé

BACKGROUND
Endoscopic internal drainage (EID) with double-pigtail stents or low negative-pressure endoscopic vacuum therapy (EVT) are treatment options for leakage after upper gastrointestinal oncologic surgery. We aimed to compare the effectiveness of these techniques.
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. Pigtail stents were changed every 4 weeks; EVT was repeated every 3-4 days until leak closure.
RESULTS
35 EID and 27 EVT patients were included, with a median (interquartile range [IQR]) leak size of 0.75 cm (0.5-1.5). Overall treatment success was 100 % (95 % confidence interval [CI] 90 %-100 %) for EID vs. 85.2 % (95 %CI 66.3 %-95.8 %) for EVT (
CONCLUSION
EID and EVT provide high closure rates for upper gastrointestinal anastomotic leaks. EVT provides a shorter treatment duration, at the cost of a higher number of procedures.

Identifiants

DOI: 10.1055/a-1375-8151 PMID: 33506454
pubmed: 33506454
doi: 10.1055/a-1375-8151
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

71-74

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare that they have no conflict of interest.

Auteurs

Carlo Felix Maria Jung (CFM)

Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany.

Rachel Hallit (R)

Department of Gastroenterology and Gastrointestinal Oncology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris and University of Paris, Paris, France.

Annegret Müller-Dornieden (A)

Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany.

Mélanie Calmels (M)

Department of Digestive Surgery, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France.

Diane Goere (D)

Department of Digestive Surgery, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France.

Ulriikka Chaput (U)

Department of Gastroenterology, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris and Sorbonne University, Paris, France.

Marine Camus (M)

Department of Gastroenterology, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris and Sorbonne University, Paris, France.

Jean Michel Gonzalez (JM)

Department of Gastroenterology, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France.

Marc Barthet (M)

Department of Gastroenterology, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France.
ORCID: 0000-0001-6589-7160

Jérémie Jacques (J)

Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France.

Romain Legros (R)

Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France.

Thierry Barrioz (T)

Department of Gastroenterology, Poitiers University Hospital, Poitiers, France.

Fabian Kück (F)

Department of Medical Statistics, University Medical Center, University of Göttingen, Göttingen, Germany.

Ali Seif Amir Hosseini (A)

Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany.

Michael Ghadimi (M)

Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany.

Steffen Kunsch (S)

Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany.

Volker Ellenrieder (V)

Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany.

Edris Wedi (E)

Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany.
Department of Gastroenterology, Gastrointestinal Oncology and Interventional Endoscopy, Sana Klinikum Offenbach, Offenbach, Germany.

Maximilien Barret (M)

Department of Gastroenterology and Gastrointestinal Oncology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris and University of Paris, Paris, France.
ORCID: 0000-0002-0566-7870

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Classifications MeSH

questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Complications postopératoires › Désunion anastomotique › Endoscopic internal drainage and low...
questionsmedicales.fr › Procédures de chirurgie opératoire › Drainage › Endoscopic internal drainage and low...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie digestive › Oesophagectomie › Endoscopic internal drainage and low...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Endoscopic internal drainage and low...
questionsmedicales.fr › Procédures de chirurgie opératoire › Techniques de fermeture des plaies › Traitement des plaies par pression négative › Endoscopic internal drainage and low...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Endoscopic internal drainage and low...