ArticleSurgical endoscopy2019
Endoscopic vacuum assisted wound closure (EVAC) device to treat esophageal and gastric leaks: assessing time to proficiency and cost.
Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 27 citations in OpenAlex.
- Indigenous endoscopic vacuum-assisted closure therapy for esophageal leaks: A novel technique.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Article
- Endoscopic vacuum-assisted closure as a first-line treatment for post-esophagectomy anastomotic leaks: A paradigm shift in management.World journal of gastrointestinal surgery · 2025Review
- Summary of the current guidelines for managing iatrogenic colorectal perforations and the evolving role of endoluminal vacuum therapy.World journal of clinical cases · 2025Article
- The Impact of EndoVAC in Addressing Post-Esophagectomy Anastomotic Leak in Esophageal Cancer Management.Journal of clinical medicine · 2024Review
- Endoluminal Vacuum Therapy as a Salvage Procedure for Difficult Anastomotic Leak Post Roux-en-Y Gastric Bypass.Cureus · 2024Article
- Applications of endoscopic vacuum therapy in the upper gastrointestinal tract.World journal of gastrointestinal endoscopy · 2023Review
- Endoscopic vacuum therapy for post-esophagectomy anastomotic dehiscence as rescue treatment: a single center case series.Esophagus : official journal of the Japan Esophageal Society · 2022Article
- Computer tomography-guided negative pressure drainage treatment of intrathoracic esophagojejunal anastomotic leakage: A case report.World journal of clinical cases · 2022Article
- Current Status of Endoscopic Vacuum Therapy in the Management of Esophageal Perforations and Post-Operative Leaks.Clinical endoscopy · 2021Article
- [Endoscopy on the surgical intensive care unit].Der Anaesthesist · 2021Article
- Factors that promote successful endoscopic management of laparoscopic sleeve gastrectomy leaks.Surgical endoscopy · 2021Article
- Endoscopic vacuum therapy with instillation (iEVT) - a novel endoscopic concept for colorectal anastomotic leak and perianal complications.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2020Article
- A large anastomotic leakage after esophageal surgery treated with endoluminal vacuum-assisted closure: a case report.Journal of surgical case reports · 2020Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEndoluminal vacuum therapy (EVAC) is an emerging procedure used to treat anastomotic leaks and/or perforations that would otherwise require surgery. The aim of this study was to determine time to proficiency in EVAC and the cost effectiveness of the procedure.
methodsWe retrospectively reviewed a prospectively maintained IRB approved database for all patients undergoing EVAC after esophageal and gastric complications between October 2013 and December 2017. Proficiency was determined by obtaining predicted estimates and analyzing the point at which average procedure time plateaued based on case volume. Total cost was calculated based on supplies and location where the procedure was performed.
resultsThere were 50 patients (17 males, 33 female), with a mean age of 52.1 years. EVAC was placed in 23 (46%) patients with esophageal injuries and 28 (56%) with gastric injuries. Two advanced endoscopists performed all EVAC procedures in this study (1 surgeon, 1 gastroenterologist). The average procedure time for all patients was 43.5 min and the average wheel in/wheel out time for all patients was 75.6 min. Analysis of the trend based on average procedure times for EVAC revealed that proficiency was obtained after 10 cases. Total cost of the procedure is significantly lower in the GI lab compared to the operating room ($4528 vs. $11889). The majority of EVAC were performed in the GI lab (62%) compared to the operating room (38%).
conclusionSuccessful outcomes in managing anastomotic leaks or intestinal perforations non-operatively has led to an increased interest in EVAC. For advanced endoscopists, time to proficiency is approximately 10 cases. Performing the procedure in the GI lab has a 2.5 reduction in total cost compared to the operating room.
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