Journal Basic Info

  • Impact Factor: 1.995**
  • H-Index: 8
  • ISSN: 2474-1647
  • DOI: 10.25107/2474-1647
**Impact Factor calculated based on Google Scholar Citations. Please contact us for any more details.

Major Scope

  •  Endocrine Surgery
  •  Vascular Surgery
  •  Emergency Surgery
  •  Urology
  •  Pediatric Surgery
  •  Minimally Invasive Surgery
  •  Bariatric Surgery
  •  Cardiovascular Surgery

Abstract

Citation: Clin Surg. 2021;6(1):3103.Research Article | Open Access

Endoscopic Vacuum Therapy for Spontaneous and Iatrogenic Esophageal Perforations: A Retrospective Study

Chengcheng Christine Zhang1 *, Henrik Nienhüser2 , Christian Rupp1 , Ronald Koschny1 , Thomas Schmidt2 , Beat P Müller-Stich2 , Thilo Hackert2 , Peter Sauer1 , Markus W Büchler2 and Anja Schaible2

1 Department of Gastroenterology, Heidelberg University Hospital, Germany 2 Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Germany

*Correspondance to: Chengcheng Christine Zhang 

 PDF  Full Text DOI: 10.25107/2474-1647.3103

Abstract

Introduction: Esophageal perforations are associated with high morbidity/mortality. Treatment of this life-threatening condition remains challenging with no consensus on the appropriate management. Endoscopic vacuum therapy represents a novel therapeutic option. This retrospective study aimed to evaluate the feasibility, effectiveness, and safety of endoscopic vacuum therapy for esophageal perforations. Methods: Twenty-seven consecutive patients with esophageal perforations were treated in our hospital, of which 7 underwent surgery (surgical repair, n=4; diversion, n=3), 1 underwent endoscopic stenting, and 19 were treated with endoscopic vacuum therapy. Results: Overall, 21 patients were treated with endoscopic vacuum therapy, including two patients following the failure of primary surgical approach. The median number of endoscopic vacuum therapy procedures per patient was 2, with a median duration of therapy of 10 days. A minor complication related to endoscopic vacuum therapy occurred in one patient (n=1/21; 4.8%), and successful closure of esophageal perforations with endoscopic vacuum therapy was achieved in 90.5% (n=19/21). Overall successful treatment of all perforations could be achieved in 77.8% of the patients (n=21/27); of the remaining six patients, five underwent a diversion, whereas one died during endoscopic vacuum therapy. The overall in-hospital mortality rate was 7.4% (n=2/27). Conclusion: Endoscopic vacuum therapy is a safe and effective approach for spontaneous and iatrogenic esophageal perforations, offers high closure rates, and can potentially reduce perforationrelated mortality.

Keywords

Cite the article

Zhang CC, Nienhüser H, Rupp C, Koschny R, Tho-mas Schmidt, Müller-Stich BP, et al. Endoscopic Vacuum Therapy for Spontaneous and Iatrogenic Esophageal Perforations: A Retrospective Study. Clin Surg. 2021; 6: 3103..

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