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Case report
First UK experience of endoscopic vacuum therapy for the management of oesophageal perforations and postoperative leaks
  1. Alaa Alakkari1,
  2. Ruchit Sood1,
  3. Simon M Everett1,
  4. Bjorn J Rembacken1,
  5. Jeremy Hayden2,
  6. Abeezar Sarela2,
  7. Noor Mohammed1
  1. 1 Gastroenterology Department, St James’s University Hospital, Leeds, UK
  2. 2 Department of Upper Gastrointestinal Surgery, St James’s University Hospital, Leeds, UK
  1. Correspondence to Dr Alaa Alakkari, Gastroenterology Department, St James’s University Hospital, Leeds LS9 7TF, UK; alaa.alakkari{at}nhs.net

Abstract

Oesophageal perforations and anastomotic leaks are associated with high morbidity and mortality. Endoscopic vacuum therapy (EVT) is a promising novel treatment that promotes healing and avoids sepsis. There are no data reporting its use in the UK. We report the first British experience of EVT in two elderly frail patients. Two patients were treated in our institution with EVT using Eso-SPONGE®. One patient had spontaneous oesophageal perforation and the other had anastomotic leakage post-Merendino oesophageal reconstruction (oesophagogastric continuity with jejunal interposition anastomosis). Both patients were over 65 years of age. One patient had 13 endoscopic Eso-SPONGE® exchanges over 8 weeks, while the other one had 6 exchanges over 4 weeks. Complete resolution of oesophageal leakage was achieved in both cases. EVT should be considered in the management of patients with oesophageal perforations and postoperative leaks. This novel therapeutic intervention has the potential to significantly reduce morbidity and mortality in these patients.

  • diagnostic and therapeutic endoscopy
  • endoscopy
  • oesophageal surgery

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Footnotes

  • Contributors AA: wrote the manuscript. RS SME BJR and NM: edited the manuscript and provided expertise regarding the clinical application of endoscopic vacuum therapy in these cases. JH and AS: provided expertise regarding the overall management and follow up of these cases.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There are no unpublished additional data.

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