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Updated: Jan 25, 2026

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
Endoscopic management of upper GI anastomotic leaks after oesophagectomy or gastrectomy: Experience from a
Claudia Sanchez-Gonzalez1, Jose Luis Fernandez Aguilar1, Javier Moreno Ruiz1
1Department of General and Digestive Surgery, Regional University Hospital of Malaga, Spain.
Abstract:
Anastomotic leaks after oesophagectomy or gastrectomy represent a major complication in upper gastrointestinal cancer surgery. This study evaluated outcomes of endoscopic management in a high-volume tertiary centre. We retrospectively analysed 29 patients treated between 2016 and 2025. Most leaks (82.8 %) were initially managed with self-expandable metal stents (SEMS), while 17.2 % received a sequential approach with endoscopic vacuum therapy (EVT) followed by SEMS. Clinical success was achieved in 89.7 % of cases, with only two requiring surgical reintervention. One death was attributed to endoscopic treatment. Median time to discharge was 21 days for SEMS and 32 days for EVT-SEMS. These findings support endoscopic therapy as a safe, effective, and organ-preserving first-line option for anastomotic leaks. The sequential use of EVT followed by SEMS is a newly described approach that may offer added benefits in selected patients and warrants further evaluation in specialised centres.
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