Related Experiment Video
Updated: Dec 30, 2025

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
Endoscopic vacuum assisted closure of esophagogastric anastomosis dehiscence: A case report
Jarosław Cwaliński1, Jacek Hermann2, Mariusz Kasprzyk3
1Department of General and Endocrynologic Surgery and Gastroenterologic Oncology, Poznan University of Medical Sciences, Poznan 60-355, Poland. cwalinski.jaroslaw@spsk2.pl.
Background:
Esophagogastric leakage is one of the most severe postoperative complications. Partial disruption of the anastomosis, can be successfully treated with an endoscopic vacuum assisted closure (E-VAC). The advantage of that method of treatment is the ability to adjust a vacuum dressing individually to the size of the dehiscence and thus to reduce the risk of a secondary fistula or abscess. The authors present two patients with postoperative gastroesophageal leakage treated successfully with E-VAC.
Case Summary:
Two male patients developed a potentially life threatening esophagogastric leakage. Patient A underwent resection of the distal half of the esophagus and upper part of the stomach due to Siewert type II adenocarcinoma of the gastroesophageal junction. Proximal resection of the stomach was performed in the patient B after massive bleeding from Mallory-Weiss tears. Both patients were treated successfully with an individually adapted E-VAC with concomitant correction of fluid and electrolyte disturbances, and treatment of sepsis with appropriate antibiotics.
Conclusion:
Endoscopic vacuum closure is an effective alternative to endoscopic stenting or relaparotomy. Through individual approach it allows a more accurate assessment of healing.
Related Concept Videos
Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
Esophageal Varices-I: Introduction
Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Esophageal Strictures-I: Introduction
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...

