초록접수 현황
| 17F-020 | English competition forum |
Endoscopic Vacuum-assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single Center Experience
Zeead AlGhamdi³, Soo Min Noh¹, Ji Yong Ahn², Jeong Hoon Lee², Hwoon-Yong Jung², Hyeong Ryul Kim³, Yong-Hee Kim³
¹Department of Internal Medicine, Asan Digestive Disease Research Institute, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea., ²Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea., ³Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : Endoscopic vacuum-assisted closure (E-VAC) therapy has been implemented successfully in a novel treatment method for the fistula and leakage. This study aimed to assess the efficacy of E-VAC therapy for patients with anastomotic leakage after esophageal surgery
Methods : Between January 2013 and April 2017, 12 patients underwent E-VAC therapy for postoperative leakage management. Their clinical features and endoscopic procedure, results of E-VAC therapy, adverse events, and survival were investigated
Results : All 12 patients were male and median age was 57 years (interquartile range [IQR], 51.5-62.8 years). The reasons for esophageal surgery were esophageal cancer (83.3%), gastrointestinal stromal tumor (8.3%), and esophageal diverticulum (8.3%). Prior to E-VAC therapy, 6 patients had failed a primary surgical repair and the median duration from esophagectomy to discovery of leakage was 13.5 days (IQR, 6-207 days). The median duration of E-VAC therapy was 25 days (IQR 13.5-34.8 days) and the average sponge exchange rate was 2.7 times during the treatment period. After E-VAC therapy, 8 patients (66.7%) had complete closure of leakage, 3 patients (25%) had decreased in leakage size, and other one (8.3%) remained unchanged. In 3 patients who had decreased the size of leakage after E-VAC therapy were treated with endoscopic and conservative management without further surgery
Conclusion : E-VAC therapy is a feasible and safe method for the treatment of anastomotic leakage after esophagectomy, if case can be selected properly.
Methods : Between January 2013 and April 2017, 12 patients underwent E-VAC therapy for postoperative leakage management. Their clinical features and endoscopic procedure, results of E-VAC therapy, adverse events, and survival were investigated
Results : All 12 patients were male and median age was 57 years (interquartile range [IQR], 51.5-62.8 years). The reasons for esophageal surgery were esophageal cancer (83.3%), gastrointestinal stromal tumor (8.3%), and esophageal diverticulum (8.3%). Prior to E-VAC therapy, 6 patients had failed a primary surgical repair and the median duration from esophagectomy to discovery of leakage was 13.5 days (IQR, 6-207 days). The median duration of E-VAC therapy was 25 days (IQR 13.5-34.8 days) and the average sponge exchange rate was 2.7 times during the treatment period. After E-VAC therapy, 8 patients (66.7%) had complete closure of leakage, 3 patients (25%) had decreased in leakage size, and other one (8.3%) remained unchanged. In 3 patients who had decreased the size of leakage after E-VAC therapy were treated with endoscopic and conservative management without further surgery
Conclusion : E-VAC therapy is a feasible and safe method for the treatment of anastomotic leakage after esophagectomy, if case can be selected properly.
책임저자: Yong-Hee Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
발표자: Zeead AlGhamdi, E-mail : dr_zeead@yahoo.com