Endoscopy 2022; 54(01): 71-74
DOI: 10.1055/a-1375-8151
Innovations and brief communications

Endoscopic internal drainage and low negative-pressure endoscopic vacuum therapy for anastomotic leaks after oncologic upper gastrointestinal surgery

Carlo Felix Maria Jung
 1  Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany
,
Rachel Hallit
 2  Department of Gastroenterology and Gastrointestinal Oncology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris and University of Paris, Paris, France
,
Annegret Müller-Dornieden
 3  Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany
,
Mélanie Calmels
 4  Department of Digestive Surgery, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
,
Diane Goere
 4  Department of Digestive Surgery, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
,
Ulriikka Chaput
 5  Department of Gastroenterology, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris and Sorbonne University, Paris, France
,
Marine Camus
 5  Department of Gastroenterology, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris and Sorbonne University, Paris, France
,
Jean Michel Gonzalez
 6  Department of Gastroenterology, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
,
 6  Department of Gastroenterology, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
,
Jérémie Jacques
 7  Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France
,
Romain Legros
 7  Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France
,
Thierry Barrioz
 8  Department of Gastroenterology, Poitiers University Hospital, Poitiers, France
,
Fabian Kück
 9  Department of Medical Statistics, University Medical Center, University of Göttingen, Göttingen, Germany
,
Ali Seif Amir Hosseini
10  Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
,
Michael Ghadimi
 3  Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany
,
Steffen Kunsch
 1  Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany
,
Volker Ellenrieder
 1  Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany
,
Edris Wedi
 1  Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany
11  Department of Gastroenterology, Gastrointestinal Oncology and Interventional Endoscopy, Sana Klinikum Offenbach, Offenbach, Germany
,
 2  Department of Gastroenterology and Gastrointestinal Oncology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris and University of Paris, Paris, France
› Author Affiliations

Abstract

Background Endoscopic internal drainage (EID) with double-pigtail stents or low negative-pressure endoscopic vacuum therapy (EVT) are treatment options for leakage after upper gastrointestinal oncologic surgery. We aimed to compare the effectiveness of these techniques.

Methods Between 2016 and 2019, patients treated with EID in five centers in France and with EVT in Göttingen, Germany were included and retrospectively analyzed using univariate analysis. Pigtail stents were changed every 4 weeks; EVT was repeated every 3–4 days until leak closure.

Results 35 EID and 27 EVT patients were included, with a median (interquartile range [IQR]) leak size of 0.75 cm (0.5–1.5). Overall treatment success was 100 % (95 % confidence interval [CI] 90 %–100 %) for EID vs. 85.2 % (95 %CI 66.3 %–95.8 %) for EVT (P = 0.03). The median (IQR) number of endoscopic procedures was 2 (2–3) vs. 3 (2–6.5; P = 0.003) and the median (IQR) treatment duration was 42 days (28–60) vs. 17 days (7.5–28; P < 0.001), for EID vs. EVT, respectively.

Conclusion EID and EVT provide high closure rates for upper gastrointestinal anastomotic leaks. EVT provides a shorter treatment duration, at the cost of a higher number of procedures.

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Publication History

Received: 30 July 2020

Accepted after revision: 27 January 2021

Publication Date:
27 January 2021 (online)

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