Review
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. May 16, 2019; 11(5): 329-344
Published online May 16, 2019. doi: 10.4253/wjge.v11.i5.329
Role of endoscopic vacuum therapy in the management of gastrointestinal transmural defects
Diogo Turiani Hourneaux de Moura, Bruna Furia Buzetti Hourneaux de Moura, Michael A Manfredi, Kelly E Hathorn, Ahmad N Bazarbashi, Igor Braga Ribeiro, Eduardo Guimarães Hourneaux de Moura, Christopher C Thompson
Diogo Turiani Hourneaux de Moura, Kelly E Hathorn, Ahmad N Bazarbashi, Christopher C Thompson, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital - Harvard Medical School, Boston, MA 02115, United States
Diogo Turiani Hourneaux de Moura, Igor Braga Ribeiro, Eduardo Guimarães Hourneaux de Moura, Department of Endoscopy of Clinics Hospital of São Paulo University, São Paulo 05403-000, Brazil
Bruna Furia Buzetti Hourneaux de Moura, Michael A Manfredi, Esophageal and Airway Atresia Treatment Center, Boston Children's Hospital - Harvard Medical School, Boston, MA 02115, United States
Author contributions: de Moura DTH and de Moura EGH conceptualized the study and wrote the manuscript; de Moura BFBH and Ribeiro IG collected data/approved final draft of the manuscript; Bazarbashi AN contributed to responsible for figure illustration/approved final draft of the manuscript; Thompson CC, Hathorn KE and Manfredi MA contributed to critical final review of manuscript/English review.
Conflict-of-interest statement: Eduardo Guimaraes Hourneaux de Moura, consultant for Boston Scientific and Olympus Moura, E is a consultant to Boston Scientific; Christopher C Thompson, reports fee as a consultant for Boston Scientific and Medtronic; fees as consultant and institutional grants from USGE Medical, Olympus, and Apollo Endosurgery. All other authors declare that they have no conflict of interest.
Open-Access: 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/
Corresponding author: Diogo Turiani Hourneuax de Moura, MD, MSc, PhD, Endoscopist, Department of Endoscopy of Clinics Hospital of São Paulo University, Av. Dr. Enéas de Carvalho Aguiar 255, Instituto Central, Prédio dos Ambulatórios, Pinheiros, São Paulo 05403-000, Brazil. dthmoura@hotmail.com
Telephone: +55-11-989997416
Received: March 8, 2019
Peer-review started: April 12, 2019
First decision: April 13, 2019
Revised: April 16, 2019
Accepted: May 1, 2019
Article in press: May 1, 2019
Published online: May 16, 2019
Core Tip

Core tip: Gastrointestinal (GI) transmural defects, including perforations, leaks, and fistulas, are difficult to manage and are associated with high rates of morbidity and mortality. Endoscopic vacuum therapy (EVT) has developed into a valuable tool for the treatment of these conditions. EVT has proven to be an effective and safe method in the intraluminal treatment of transmural defects, as it promotes changes in perfusion, causes microdeformation and macrodeformation, and decreases bacterial contamination, secretion, and local edema to facilitate healing. In this review, we discuss the mechanism of action, materials, techniques, efficacy, and safety of EVT in the management of patients with transmural GI defects.