Experience with endoluminal vacuum therapy in the management of esophageal anastomotic leakage in newborns with esophageal atresia: A case series
Keywords:Esophagoplasty dehiscence, Endoluminal vacuum therapy (EVT), Esophageal atresia
Background: The management of dehiscence of esophageal anastomosis is challenging and requires a multidisciplinary approach. Endoluminal vacuum therapy (EVT) has shown promising results.
Case Presentation: Herein we present the data of two cases with esophageal atresia who developed esophageal anastomotic leakage, during 2021-2022, and who underwent EVT. The first case had 60% dehiscence of the anastomosis, anastomotic leak repair was performed followed by esophageal EVT placement. In the second case, the dehiscence was limited to 10%, and only esophageal EVT was provided. Within four and six days of EVT, upper gastrointestinal endoscopy and fluoroscopy were performed which showed tissue proliferation in situ and the absence of contrast leakage. Both patients were able to resume oral tolerance on the 4th day.
Conclusion: Esophageal EVT has shown promising results in the management of esophageal anastomotic leakage in newborns with esophageal atresia.
Comella A, Tan Tanny SP, Hutson JM, Omari TI, Teague WJ, Nataraja RM, et al. Esophageal morbidity in patients following repair of esophageal atresia: A systematic review. J Pediatr Surg. 2021; 56:1555-63. Available from: https://doi.org/10.1016/j.jpedsurg.2020.09.010.
Manfredi MA, Clark SJ, Staffa SJ, Ngo PD, Smithers CJ, Hamilton TE, et al. Endoscopic esophageal vacuum therapy: a novel therapy for esophageal perforations in pediatric patients. J Pediatr Gastroenterol Nutr. 2018; 67:706–12. Available from: https://doi.org/10.1097/MPG.0000000000002073.
Safronov AA. Vacuum therapy of trophic ulcers with simultaneous autoplastic skin transplantation (Article in Russian). Novyi Khirurgicheskii Arkhiv. 1962; 3:3–8.
Still S, Mencio M, Ontiveros E, Burdick J, Leeds SG. Primary and rescue endoluminal vacuum therapy in the management of esophageal perforations and leaks. Ann Thorac Cardiovasc Surg. 2018; 24:173-9. Available from: https://doi.org/10.5761/atcs.oa.17-00107.
Bludau M, Hölscher AH, Herbold T, Leers JM, Gutschow C, Fuchs H, et al. Management of upper intestinal leaks using an endoscopic vacuum-assisted closure system (E-VAC). Surg Endosc. 2014; 28:896-901. Available from: https://doi.org/10.1007/s00464-013-3244-5.
Huang C, Leavitt T, Bayer LR, Orgill DP. Effect of negative pressure wound therapy on wound healing. Curr Probl Surg. 2014; 51:301-31. Available from: https://doi.org/10.1067/j.cpsurg.2014.04.001.
Kaczmarek DJ, Heling DJ, Strassburg CP, Katzer D, Düker G, Strohm J, et al. Management of esophageal perforations in infants by endoscopic vacuum therapy: a single center case series. BMC Gastroenterol. 2022; 22:282. Available from: https://doi.org/10.1186/s12876-022-02346-2.
Schorsch T, Müller C, Loske G. Endoscopic vacuum therapy of anastomotic leakage and iatrogenic perforation in the esophagus. Surg Endosc. 2013; 27:2040-5. Available from: https://doi.org/10.1007/s00464-012-2707-4.
Ritz LA, Hajji MS, Schwerd T, Koletzko S, von Schweinitz D, Lurz E, et al. Esophageal perforation and EVAC in pediatric patients: A case series of four children. Front Pediatr. 2021; 9:727472. Available from: https://doi.org/10.3389/fped.2021.727472.
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