Endoluminal Vacuum Therapy: How I Do It.
J Gastrointest Surg
; 23(5): 1037-1043, 2019 05.
Article
en En
| MEDLINE
| ID: mdl-30671790
ABSTRACT
Perforations and leaks of the gastrointestinal tract are difficult to manage and are associated with high morbidity and mortality. Recently, endoscopic approaches have been applied with varying degrees of success. Most recently, the use of endoluminal vacuum therapy has been used with high success rates in decreasing both morbidity and mortality. Under an IRB-approved prospective registry that we started in July 2013, we have been using endoluminal vacuum therapy to treat a variety of leaks throughout the GI tract. The procedure uses an endosponge connected to a nasogastric tube that is endoscopically guided into a fistula cavity in order to facilitate healing, obtain source control, and aid in reperfusion of the adjacent tissue with debridement. Endoluminal vacuum therapy has been used on all patients in the registry. Overall success rate for healing the leak or fistula is 95% in the esophagus, 83% in the stomach, 100% in the small bowel, and 60% of colorectal cases. The purpose of this report is to review the history of endoluminal wound vacuum therapy, identify appropriate patient selection criteria, and highlight "pearls" of the procedure. This article is written in the context of our own clinical experience, with a primary focus on a "How I Do It" technical description.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Fístula del Sistema Digestivo
/
Terapia de Presión Negativa para Heridas
/
Fuga Anastomótica
/
Enfermedades Gastrointestinales
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
J Gastrointest Surg
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos