OGC P34 Endoscopy vacuum therapy for anastomotic leak after oesophagectomy – A single centre's experience


 
 
 Anastomotic leak is one of the major complications following oesophagectomy and is associated with a prolonged ICU and hospital stay with high mortality. Over the years, endoscopic vacuum therapy (EVT) has an evolving role in managing anastomotic leak. The aim of this study was evaluate our experience in the use of EVT in managing anastomotic leak.
 
 
 
 A retrospective analysis was conducted in patients who underwent elective oesophagectomy at our tertiary centre from May 2021 to April 2022. Patient demographics, complication profiles, length of stay (LOS) and survival outcomes were collected. The details of endoscopic procedure, therapy results, and adverse events were evaluated. Endo-SPONGE® by B Braun Medical Ltd was used at our centre.
 
 
 
 Over the last 12 months, 3 out of 11 patients (27.3%) who had anastomotic leak were treated with EVT. All 3 patients were males and diagnosed with anastomotic leak on Day 8, 9, 9. Two patients were treated with a stent at the time of the diagnosis and the management changed to Endo-Sponge on the subsequent endoscopy as the defect increased in size. They required 3 and 8 times of sponge exchange respectively. One patient was managed with Endo-Sponge at the time of diagnosis and required 7 times of sponge exchange. The successful anastomotic leak healing rate was 100% and none of them required further endoscopic or surgical interventions. The median changing time interval of sponges was 3 days (range 2–5 days). The average sponge exchange rate was 6 times. The median duration of EVT was 25 days (range 18–29 days). No other adverse events occurred during EVT. The average LOS was 49.3 days.
 
 
 
 EVT is an effective and safe treatment option in patients with anastomotic leak post oesophagectomy for oesophageal cancer. With careful patient selection, EVT can be considered as the first-line treatment instead of surgery. Future studies involving a greater number of patients are essential to evaluate the efficacy of EVT.
