Stent-over-sponge (SOS): a novel technique complementing endosponge therapy for foregut leaks and perforations

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Medical Device Innovation

Background:

• Endoluminal vacuum therapy (EVT) is a recognized treatment for foregut wall injuries.
• Traditional methods like clips and stents have limitations in managing complex defects.
• Improving vacuum efficacy and maintaining esophageal patency are key challenges in EVT.

Purpose of the Study:

• To introduce and evaluate the stent-over-sponge (SOS) technique.
• To assess the efficacy of SOS in treating infected upper gastrointestinal wall defects.
• To compare SOS performance as a first-line versus second-line treatment.

Main Methods:

• The study involved twelve patients with infected upper gastrointestinal wall defects.
• The stent-over-sponge (SOS) technique was applied.
• Patient data on indications, treatment lines, and outcomes were collected.

Main Results:

• SOS was used for anastomotic leakage (11 patients) and chronic fistula (1 patient).
• As a first-line treatment, SOS achieved a 71.4% success rate (5/7 patients).
• As a second-line treatment after failed EVT, SOS had an 80% success rate (4/5 patients), with an overall success rate of 75% (9/12 patients) and no severe adverse events.

Conclusions:

• The stent-over-sponge (SOS) technique is effective for severe infected foregut wall defects.
• SOS demonstrates efficacy as both a primary treatment and salvage therapy after EVT failure.
• Further comparative prospective studies are recommended to validate these preliminary findings.