Kouladouros K. Applications of endoscopic vacuum therapy in the upper gastrointestinal tract. World J Gastrointest Endosc 2023; 15(6): 420-433 [PMID: 37397978 DOI: 10.4253/wjge.v15.i6.420]
Corresponding Author of This Article
Konstantinos Kouladouros, MD, Consultant Physician-Scientist, Central Central Interdisciplinary Endoscopy, Surgical Clinic, Mannheim University Hospital, University of Heidelberg, Thedor-Kutzer-Ufer 1-3, Mannheim 68167, Baden-Wuerttemberg, Germany. kouladou@otenet.gr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Evidence Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jun 16, 2023; 15(6): 420-433 Published online Jun 16, 2023. doi: 10.4253/wjge.v15.i6.420
Applications of endoscopic vacuum therapy in the upper gastrointestinal tract
Konstantinos Kouladouros
Konstantinos Kouladouros, Central Interdisciplinary Endoscopy, Surgical Clinic, Mannheim University Hospital, University of Heidelberg, Mannheim 68167, Baden-Wuerttemberg, Germany
Author contributions: Kouladouros K performed the literature research, wrote and revised the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Konstantinos Kouladouros, MD, Consultant Physician-Scientist, Central Central Interdisciplinary Endoscopy, Surgical Clinic, Mannheim University Hospital, University of Heidelberg, Thedor-Kutzer-Ufer 1-3, Mannheim 68167, Baden-Wuerttemberg, Germany. kouladou@otenet.gr
Received: April 3, 2023 Peer-review started: April 3, 2023 First decision: May 12, 2023 Revised: May 15, 2023 Accepted: June 2, 2023 Article in press: June 2, 2023 Published online: June 16, 2023
Abstract
Endoscopic vacuum therapy (EVT) is an increasingly popular treatment option for wall defects in the upper gastrointestinal tract. After its initial description for the treatment of anastomotic leaks after esophageal and gastric surgery, it was also implemented for a wide range of defects, including acute perforations, duodenal lesions, and postbariatric complications. Apart from the initially proposed handmade sponge inserted using the “piggyback” technique, further devices were used, such as the commercially available EsoSponge and VAC-Stent as well as open-pore film drainage. The reported pressure settings and intervals between the subsequent endoscopic procedures vary greatly, but all available evidence highlights the efficacy of EVT, with high success rates and low morbidity and mortality, so that in many centers it is considered to be a first-line treatment, especially for anastomotic leaks.
Core Tip: Endoscopic vacuum therapy (EVT) is a novel and effective endoscopic treatment option for anastomotic leaks and perforations in the upper gastrointestinal tract. Through the wide variety of available materials, EVT can be individually applied in almost every part of the oesophagus, the stomach and the duodenum with a clinical success rate of > 80% and low morbidity and mortality.
