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Updated: Jan 26, 2026
04:05
Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
753
Endoscopic vacuum therapy for postoperative esophageal leak
Yang Won Min1, Taewan Kim1, Hyuk Lee1
1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
BMC Surgery
|April 13, 2019
Summary
Endoscopic vacuum-assisted closure (EVAC) effectively treats esophageal anastomotic leaks after cancer surgery. Neoadjuvant therapy and larger fistula size may prolong EVAC treatment duration, requiring careful patient selection and management.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Endoscopy
Background:
- Anastomotic leak is a frequent and severe complication after esophagectomy.
- Endoscopic vacuum-assisted closure (EVAC) presents a promising non-surgical approach for managing these leaks.
- Esophageal cancer surgery carries a significant risk of anastomotic complications.
Purpose of the Study:
- To assess the efficacy and success rates of EVAC in treating anastomotic leaks post-esophagectomy for cancer.
- To identify clinical factors associated with prolonged EVAC treatment duration (≥ 21 days).
Main Methods:
- Retrospective analysis of 20 patients with esophageal anastomotic leaks after esophagectomy.
- Evaluation of EVAC treatment efficacy, success rates, and duration.
- Identification of factors correlating with treatment duration.
Main Results:
- High treatment success rate (95.0%) in 19 out of 20 patients.
- Median EVAC treatment duration was 14.5 days, with a median of 5 interventions.
- Neoadjuvant treatment was significantly linked to longer EVAC treatment duration.
Conclusions:
- EVAC is an effective non-surgical option for esophageal anastomotic leaks following esophagectomy.
- Neoadjuvant treatment and larger fistula size are associated with extended EVAC treatment duration.
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