2023-06-19 15:07:06
Endoscopic vacuum therapy (EVT) is a promising organ-sparing treatment for esophageal perforations, with an 89% success rate. This is the conclusion of a retrospective study, partly conducted at Amsterdam UMC.
The aim of this study was to describe the initial experience with ERT in patients with iatrogenic oesophageal perforations, due to Boerhaave syndrome or other perforations not related to upper GI surgery. For this purpose, retrospective data were collected from patients treated between 2018 and 2021 in 5 hospitals in 3 European countries. The primary endpoint was successful defect closure by EVT, with or without the use of other endoscopic modalities.
A total of 27 patients could be included (median age: 71 years). The success rate was 89% (24/27; 95% CI 77-100). Successful defect closure with EVT alone was achieved in 19/27 patients (70 %). Treatment failed in 3 patients: 1 patient died of stroke due to septic embolism after 4 days of EVT and another from pulmonary embolism after 14 days; 1 patient underwent esophagectomy because no improvement of the defect was seen. 3 patients died; in addition to the above 2 patients, a third died 8 days after a successful ERT, probably from a cardiac cause.
2 side effects occurred: in 1 case the defect was magnified by the scope during sponge change, in addition there was bleeding during sponge removal. The median duration of treatment was 12 days (IQR 6-16) with 1 sponge change (IQR 1-3).
Bron:
Luttikhold J, Pattynama LM, Seewald S, et al. Endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort study. Endoscopy. 2023 Apr 20. Online ahead of print.
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