Endoscopy 2023; 55(S 02): S26-S27
DOI: 10.1055/s-0043-1765055
Abstracts | ESGE Days 2023
Oral presentation
Esophagus – transmural defects: vacuum it or stent it? 20/04/2023, 11:30 – 12:30 Liffey Meeting Room 2

Endoscopic vacuum therapy for the treatment of upper gastrointestinal defects. Results of a Spanish multicenter registry

Authors

  • O. Garcia Sendino

    1   Hospital Clínic de Barcelona, Barcelona, Spain

  • D. Momblan

    2   Barcelona, Spain

  • D. Busquets

    3   Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain

  • A. Gimeno-Garcia

    4   Hospital Universitario de Canarias, La Laguna, Spain

  • D. Juzgado

    5   Madrid, Spain

  • J. García-Lledó

    5   Madrid, Spain

  • E. Ferrero

    5   Madrid, Spain

  • J. Tejedor

    6   Hospital of Cabueñes, Gijón, Spain

  • F. Junquera

    7   Hospital Parc Taulí de Sabadell, Sabadell, Spain

  • J. Díaz-Tasende

    8   University Hospital October 12, Madrid, Spain

  • M. Moris

    9   Marqués de Valdecilla University Hospital, Santander, Spain

  • J. B. Gornals

    2   Barcelona, Spain

  • C. Garrido

    10   Palma de Mallorca, Spain

  • S. Gonzalez

    5   Madrid, Spain

  • C. Guarner-Argente

    2   Barcelona, Spain

  • A. Repiso

    11   Toledo, Spain

  • J. M. Esteban

    5   Madrid, Spain

  • C. Loras

    12   Terrassa, Spain

  • A. Seoane

    2   Barcelona, Spain

  • A. Cardenas

    2   Barcelona, Spain

  • H. Cordova

    1   Hospital Clínic de Barcelona, Barcelona, Spain

  • A. Fernandez-Simon

    2   Barcelona, Spain

  • X. Morales

    2   Barcelona, Spain

  • A. Ibarzabal

    2   Barcelona, Spain

  • J. Llach

    1   Hospital Clínic de Barcelona, Barcelona, Spain

  • A. M. De Lacy

    2   Barcelona, Spain
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    Aims To evaluate the effectiveness and safety of endoscopic vacuum therapy (EVT) for the treatment of upper gastrointestinal (GI) defects. To assess risk factors associated with EVT failure and in-hospital mortality in these patients.

    Methods Retrospective study of a Spanish multicenter registry where all patients treated with EVT were consecutively included between November 2018 and March 2022.

    Results 102 patients from 18 hospitals were included, 89 (87.3%) with an anastomotic dehiscence and 13 (12.7%) with an acute perforation. 20 (19.6%) patients were reoperated and 19 (18.6%) received an esophageal stent as primary treatment before starting EVT. The average delay in the onset of EVT was 13 days (IQR 7-28). Intracavitary EVT was used in 66 (64.7%) cases and intraluminal EVT in 36 (35.3%). The average number of sponges was 5 (IQR 3-7). The median duration of EVT was 19 days (IQR 11-27). Closure of the defect was achieved in 84 cases (82%). 6 patients (5.9%) presented some adverse event related to EVT: 1 fatal bleeding, 1 jejunal perforation and 4 minor events. 11 (10.7%) patients presented anastomotic strictures. In-hospital mortality was 12.7% (n=13). The delay in the initiation of EVT and the development of a fistula during therapy were independent predictors of EVT failure. EVT failure and the development of pneumonia were independent predictors of in-hospital mortality.

    Conclusions EVT is effective and safe for treating upper GI defects. Early use could improve the effectiveness of the therapy and therefore reduce the in-hospital mortality of these patients.


     

    Conflicts of interest

    A. M. de Lacy is a consultant for B. BraunA. Cardenas is a consultant for B. Braun and Boston ScientificA. Ibarzabal is a consultant for B. BraunD. Momblan is a consultant for B. BraunOriol Sendino is a consultant for B.Braun

    Publikationsverlauf

    Artikel online veröffentlicht:
    14. April 2023

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