Original articleClinical endoscopyEndoscopic vacuum therapy for the management of upper GI leaks and perforations: a multicenter retrospective study of factors associated with treatment failure (with video)
Graphical abstract
Section snippets
Patients
Four referral hospitals participated in this retrospective, multicenter study. Between September 2015 and February 2020, 119 patients who underwent EVT for UGI perforation or leak at 4 tertiary hospitals (Severance Hospital, Samsung Medical Center, Incheon St Mary’s Hospital, and Gangnam Severance Hospital) were included in this study. Demographic data, including age, sex, comorbidities, and cause of perforation or leak, were retrospectively obtained from medical records. Clinical data, such as
Patient characteristics
One hundred nineteen patients with a UGI perforation or leak underwent EVT. Their baseline characteristics are shown in Table 1. The etiologies for EVT were anastomosis site leak, iatrogenic perforation, and others. Among the patients who underwent EVT, 113 had undergone surgery before EVT. The indications for surgery were esophageal cancer, gastric cancer, both esophageal and gastric cancer, and benign disease. Also, 6 patients had not undergone surgery before EVT. The indications for EVT were
Discussion
In this study, neoadjuvant treatment and the intraluminal method were independent risk factors for EVT failure. Several reports have shown the effectiveness of EVT for the treatment of UGI leaks and perforations.19,24,25,32,33 A previous meta-analysis19 reported that healing of the perforation occurred in 66.7% to 100% of cases treated with EVT, with an overall mortality rate of 0% to 12.8%.24,25,32,33 However, the included studies were limited to case series and retrospective cohort studies
Acknowledgment
We thank Nak-Hoon Son, PhD, for his comments on the statistical analysis and Dong Su Jang, PhD, for medical illustrations for this article.
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DISCLOSURE: All authors disclosed no financial relationships.
If you would like to chat with an author of this article, you may contact Dr Park at [email protected].
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Drs Jung and Huh contributed equally to this article.