ArticleChirurgie (Heidelberg, Germany)2023
[Endoscopic negative pressure treatment : From management of complications to pre-emptive active reflux drainage in abdominothoracic esophageal resection-A new safety concept for esophageal surgery].
Article in Chirurgie (Heidelberg, Germany), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Safety and short-term oncological outcomes of multimodal modified overlap esophagojejunostomy in total laparoscopic total gastrectomy for elderly patients.American journal of translational research · 2026Article
- Presentation of a new preemptive endoscopic treatment concept in duodenal interventions exemplified by an iatrogenic duodenal perforation after percutaneous transrenal nephrostomy. English version.Chirurgie (Heidelberg, Germany) · 2025Article
- [Presentation of a new pre-emptive endoscopic treatment concept in duodenal interventions exemplified by an iatrogenic duodenal perforation after percutaneous transrenal nephrostomy. German version].Chirurgie (Heidelberg, Germany) · 2025Article
- Endoscopic Treatment of Anastomotic Leakage in the Upper Gastrointestinal Tract.Visceral medicine · 2025Review
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Authors and funding
6 authors.
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Abstract
introductionEarly postoperative reflux (PR) can compromise anastomotic healing after Ivor Lewis esophagectomy (ILE) and poses a risk for aspiration. Anastomotic insufficiency is the most threatening surgical complication. We present the protective method of pre-emptive active reflux drainage (PARD) with simultaneous enteral feeding. We report our experience with this new safety concept in esophageal surgery in a cohort of 43 patients. MATERIALS AND
methodsFor PARD we use a double lumen open porous film drainage (dOFD). To create the dOFD, the gastric tube of a Trelumina probe (Freka®Trelumina, Fresenius) is coated with a double-layered open-pore drainage film (Suprasorb®CNP drainage film, Lohmann & Rauscher) over a length of 25 cm. The dOFD is endoscopically inserted into the tubular stomach intraoperatively after completion of the anastomosis. Continuous negative pressure is applied with an electronic pump (-125 mm Hg). The PR is continuously aspirated completely and the stomach and anastomotic region are decompressed. At the same time, nutrition is delivered via an integrated intestinal tube. Depending on the results of the endoscopic control after 5 days, PARD is either continued or terminated.
resultsDuring the observation period (2017-2023), PARD was used in all patients (n = 43) with ILE. The healing rate under PARD was 100% and healing was observed in all anastomoses. No additional endoscopic procedures or surgical revisions of the anastomoses were required. The median duration of PARD was 8 days (range 4-21). We observed problems in the healing of the anastomosis in 20 of 43 patients (47%) for whom we defined endoscopic criteria for at-risk anastomosis.
conclusionsOur results suggest that PARD has a strong protective effect on anastomotic healing and may reduce the risk of anastomotic insufficiency. The integrated feeding tube of the dOFD allows early postoperative enteral feeding while simultaneously applying negative pressure. PARD appears to prevent the negative consequences of impaired anastomotic healing.
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