ENDOSCOPIC VACUUM THERAPY (EVT) FOR THE CLOSURE OF UPPER GASTROINTESTINAL DEFECTS: PRELIMINARY RESULTS FROM THE SPANISH EVT REGISTRY

Aims This study reports clinical outcomes from the Spanish EVT registry.

Methods In November 2018, a Spanish registry of patients with upper gastrointestinal tract defects who underwent EVT using Eso-SPONGE was initiated. All demographic, clinical and technical variables related to the procedure were collected in a Redcap-type database. The patients were followed for 6 months to assess the persistence of the closure and/or the appearance of adverse events.

Results Sixty-four patients were included in the study. The most frequent indications were: anastomotic suture dehiscence after esophageal neoplasia surgery (n=15), cardial neoplasia surgery (n=6), gastric neoplasia surgery (n=12), obesity surgery (n=10) and spontaneous esophageal perforation (n=4). The median size of the cavity was 6.7 x 3.6 cm. Median time to initial EVT was 8 days after the surgery. The median duration of EVT was 19 days. The median number of sponges in place was 5 and the sponge exchange interval was 3.8 days. In 53 cases (83%), closure of the defect was achieved. Seven patients (11%) presented stricture, 2 (3%) presented new-onset pneumonia and 1 (1.6%) patient presented an aortoesophageal fistula. Hospitals with a case volume greater than 5 had a significantly higher closure rate (90% vs 69%; p=0.04). On the other hand, patients with previous treatment with stent placement had significantly lower closure rate (89% vs 37%; p=0.003).

Conclusions EVT is an effective and safe technique for the treatment of upper gastrointestinal perforations and anastomotic leaks.

Publication History

Article published online:
14 April 2022