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Upper GI tract
Endoluminal vacuum therapy for the treatment and prevention of anastomotic leakages, and for the treatment of perforations, in the upper GI tract.
Anastomotic leakages or other defects in the upper gastrointestinal tract can have serious consequences for the affected patients. Different parameters, like the size, location, time to diagnosis of the lesion, but also the general condition of the patient, have a significant influence on the clinical outcome of the patient. Often this situation is accompanied by symptoms of sepsis and a significant morbidity rate with corresponding substantial mortality rate. For this reason the treatment of this clinical situation is often a challenge for the clinician.
Besides surgical examination and the endoscopic stent system, good experiences have been obtained with the Endo-SPONGE® therapy for the lower gastrointestinal tract. Endoluminal vacuum therapy for the upper gastrointestinal is now available – Eso-SPONGE®.
Anastomotic leakage is one of the most dreaded complications after esophagectomy, with an incidence reported to up to 30%, [1-10] and a high morbidity and mortality associated. [1-10] Patients with conditions such as calcification of arteries, heart failure, hypertension, renal insufficiency, obesity or diabetes have an increased risk of anastomotic leakage after esophagectomy. [11], [12], [13] For these patients there is the option to use Eso-SPONGE® to help prevent the development of anastomotic leakages.
*The upper GI tract refers to the oesophagus, stomach and duodenum, endoscopically accessible within the range of the overtube length.
The basic principle of Eso-SPONGE® vacuum therapy consist of inserting an open-pored sponge into the leakage cavity or in the endoluminal area or the defect using a flexible endoscope. A drainage tube connected to the sponge is routed through the nose and connected to a low vacuum pump. Through the application of negative pressure, effective continuous drainage is achieved and a build up of secretion avoided. The sponge induces cleaning away of fibrin coatings as well as inducing granulation tissue growth to close the defect.
Endoluminal vacuum therapy for the treatment of anastomotic leakages and perforations in the upper GI tract.
Endoluminal vacuum therapy for the prevention of anastomotic leakages in the upper GI tract.
How to use the variable speed medical vacuum pump MV 1 (MTG Sulzbach, Germany – distributed by B. Braun).
According to the Robert Koch Institute (RKI), the number of new cases suffering of a esophageal carcinoma has doubled since 1990 in Germany. The older age groups were more affected. Taking into account an unchanged morbidity rate and survival rate, a further increase of 10-year prevalence rate is expected in the coming years to 10.500 patients.
Negative pressure to treat anastomotic leakages and perforations in the upper GI has recently demostrated potential to become the new standard of care for these patients. [8], [10]
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