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Updated: Apr 13, 2026
04:05
Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
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Endoluminal Vacuum Therapy for Esophageal Injuries: Exploratory Analysis of Success
Jae M Cho1, Amir Karimipour1, Mhmod Kadom1
1Division of Thoracic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
The Journal of Surgical Research
|April 11, 2026
Summary
Endoluminal vacuum therapy (EVT) effectively treats esophageal defects. Success is linked to better nutrition and less severe sepsis, highlighting areas for treatment optimization in future trials.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Critical Care Medicine
Background:
- Endoluminal vacuum therapy (EVT) shows promise for esophageal conditions like leaks, perforations, and fistulas.
- Limited evidence exists for optimizing EVT treatment protocols.
- Identifying predictors of EVT success is crucial for improving patient outcomes.
Purpose of the Study:
- To identify clinical and biological predictors of success in endoluminal vacuum therapy (EVT).
Main Methods:
- A single-center retrospective review of patients undergoing EVT between 2020 and 2025.
- EVT success was defined as complete defect closure or size reduction.
- Failure was defined as lack of progress or defect enlargement.
Main Results:
- 39 out of 49 patients (79.6%) experienced treatment benefit from EVT.
- Successful EVT was associated with higher BMI, improved post-treatment albumin, lower white blood cell counts, and reduced sepsis.
- EVT demonstrated effectiveness across various esophageal defect types and locations, with defects up to 4 cm successfully treated.
Conclusions:
- EVT is a versatile and effective treatment for esophageal leaks, perforations, and fistulas.
- Nutritional status and sepsis severity are significant correlates of EVT success.
- Prospective trials are needed to establish protocols for nutritional optimization and sepsis control in EVT patients.
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