Background: Anastomotic leaks are major complications following upper gastro-intestinal (UGI) surgery, associated with high morbidity and mortality. Despite being the most common serious complication, the standard treatment for anastomotic leaks remains unclear. Endoscopic vacuum therapy (EVT) is a promising method - we aimed to evaluate the treatment success in our treated population.
Methods: We retrospectively analyzed the data from all patients who underwent EVT for anastomotic leaks after esophageal surgery between 20/06/2018 and 27/11/2023.
Results: We included 11 patients, 10 of them were male. Commercial kits were used in 9 and manual kits in 2. All but one underwent esophagectomy; 2 received neoadjuvant chemotherapy, 9 received both chemo and radiotherapy. The median size of fistula opening was 20mm. A median of 12 interventions per patient was registered. The average interval between leak diagnosis and first treatment was 84 days (median 20). 6 patients had complete closure of the defect, while 4 had partial closures (followed by stent placement in 3) and there was one treatment failure. Four patients presented sponge-related complications: two migrations and two fragmented sponges. Due to pulmonary disease, we had to stop the treatment in one patient.
Conclusion: EVT is a safe and effective treatment for management of anastomotic leaks following esophageal surgery. However, larger studies are needed to identify factors associated to treatment success and to assess its cost-benefit results.
