ArticleSurgical endoscopy2022
Evolution of endoscopic vacuum therapy for upper gastrointestinal leakage over a 10-year period: a quality improvement study.
Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 18 citations in OpenAlex.
- Endoscopic vacuum therapy for anastomotic leakage after upper gastrointestinal surgery.Endoscopy · 2023Trial
- Colon interposition after esophagectomy: a 15-year single-center experience.Langenbeck's archives of surgery · 2026Article
- Too fast or too slow?: Considerations in the era of enhanced recovery and FAST Track for upper GI surgery.Surgical endoscopy · 2026Article
- Interventional Endoscopy for the Management of Post-Surgical Leaks and Fistulas: A Scoping Review.Journal of clinical medicine · 2026Review
- Article
- The effects of endoscopic vacuum therapy for non-operative treatment of anastomotic leakage on oncological outcomes in rectal cancer patients.Langenbeck's archives of surgery · 2025Article
- Multimodal therapeutic options for esophageal perforations-a single-center experience.Frontiers in surgery · 2025Article
- Pull-through endoscopic vacuum-assisted closure therapy for complicated leaks of the gastrointestinal tract: Novel technique.Endoscopy international open · 2025Article
- Proficiency in bariatric surgery may shorten the learning curve for minimally-invasive D2 gastrectomy.Langenbeck's archives of surgery · 2024Article
- Additional over-the-scope-clip closure can shorten endoscopic vacuum therapy for postoperative upper gastrointestinal leakage.Endoscopy international open · 2024Article
- Surgical options in retrosternal oesophageal reconstruction.Langenbeck's archives of surgery · 2024Article
- Endoscopic vacuum therapy in the upper gastrointestinal tract.Frontiers in gastroenterology (Lausanne, Switzerland) · 2024Article
- Endoscopic Vacuum Therapy of Upper Gastrointestinal Anastomotic Leaks: How to Deal with the Challenges (with Video).Life (Basel, Switzerland) · 2023Review
- Don't be afraid of black holes: Vacuum sponge and vacuum stent treatment of leaks in the upper GI tract-a case series and mini-review.Frontiers in surgery · 2023Review
- Use of endoluminal vacuum therapy after anastomotic leak in a gynecologic oncology patient with rectosigmoid resection: A case report.Gynecologic oncology reports · 2022Article
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Authors and funding
15 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEndoscopic vacuum therapy (EVT) is an effective treatment option for leakage of the upper gastrointestinal (UGI) tract. The aim of this study was to evaluate the clinical impact of quality improvements in EVT management on patients' outcome.
methodsAll patients treated by EVT at our center during 2012-2021 were divided into two consecutive and equal-sized cohorts (period 1 vs. period 2). Over time several quality improvement strategies were implemented including the earlier diagnosis and EVT treatment and technical optimization of endoscopy. The primary endpoint was defined as the composite score MTL30 (mortality, transfer, length-of-stay > 30 days). Secondary endpoints included EVT efficacy, complications, in-hospital mortality, length-of-stay (LOS) and nutrition status at discharge.
resultsA total of 156 patients were analyzed. During the latter period the primary endpoint MTL30 decreased from 60.8 to 39.0% (P = .006). EVT efficacy increased from 80 to 91% (P = .049). Further, the need for additional procedures for leakage management decreased from 49.9 to 29.9% (P = .013) and reoperations became less frequent (38.0% vs.15.6%; P = .001). The duration of leakage therapy and LOS were shortened from 25 to 14 days (P = .003) and 38 days to 25 days (P = .006), respectively. Morbidity (as determined by the comprehensive complication index) decreased from 54.6 to 46.5 (P = .034). More patients could be discharged on oral nutrition (70.9% vs. 84.4%, P = .043).
conclusionsOur experience confirms the efficacy of EVT for the successful management of UGI leakage. Our quality improvement analysis demonstrates significant changes in EVT management resulting in accelerated recovery, fewer complications and improved functional outcome.
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