Iatrogenic perforation of esophagus successfully treated with Endoscopic Vacuum Therapy (EVT)

医源性食管穿孔经内镜真空疗法(EVT)成功治疗

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Abstract

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. RESULTS: Esophageal perforations were located from the cricopharyngeus (4/10) to the esophagogastric junction (2/10). EVT was feasible in all patients. Eight patients were treated with intraluminal EVT, one with intracavitary EVT, and one with both types of treatments. All perforations (100 %) were healed in within a median of (3 - 7) days. No stenosis occurred, no complications were observed, and no additional operative treatment was necessary. CONCLUSIONS: Our study suggests that intraluminal EVT will play an important role in endoscopic management of esophageal perforation.

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