Evidence map›Paper›PMID 40691570›Full record

SynthesisBMC surgery2025

VacStent as a novel therapeutic approach for esophageal perforations and anastomotic leaks- a systematic review of the literature.

Dimitrios Kehagias, Sameh Abogabal, Charalampos Lampropoulos, Muhammad Ijlal Haider, Ioannis Kehagias, Prashant Jain, Vincent Wong

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Article
  5. Endoscopic Vacuum Therapy: When and How to Use It?GE Portuguese journal of gastroenterology
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Dimitrios KehagiasDepartment of Upper Gastrointestinal Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK. dimikech@gmail.com.ORCID http://orcid.org/0000-0001-7691-6355
Sameh AbogabalDepartment of Upper Gastrointestinal Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK.
Charalampos LampropoulosIntensive Care Unit, Saint Andrew's General Hospital of Patras, Patras, Greece.
Muhammad Ijlal HaiderDepartment of Upper Gastrointestinal Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK.
Ioannis KehagiasDepartment of Surgery, University General Hospital of Patras, Patras, Greece.
Prashant JainDepartment of Upper Gastrointestinal Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK.
Vincent WongDepartment of Upper Gastrointestinal Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerforation and anastomotic leak (AL) of the esophagus remain a dreaded complication for surgeons, endoscopists and patients. The VacStent is a novel endoscopic device, combining the benefits of a self-expandable metallic stent (SEMS) and endoscopic vacuum therapy (EVT). This systematic review aims to investigate the efficacy and clinical outcomes associated with the use of the VacStent.

methodsA systematic literature review was conducted in PubMed and Google Scholar electronic databases using keywords and Medical Subject Headings terms. Peer-reviewed studies in English language that reported the use of VacStent for transmural defects of any cause of the esophagus and gastroesophageal junction (GEJ) were included. Data regarding technical details of the VacStent, outcomes, and complications were extracted and presented in a narrative synthesis. Clinical success was defined as closure of the defect without requiring further intervention.

resultsOf the 153 articles identified after searching, nine studies were deemed eligible and included in the final analysis. The methodological quality of the included studies was generally moderate. Sixty-five patients underwent VacStent treatment for the following indications: AL (70%), Boerhaave syndrome (10%), iatrogenic perforation (10%), and other causes (10%). The mean interval between VacStent changes was 5.3 (2-8) days. Prior endoscopic interventions, including SEMS, clips, and EVT, had been performed in 25 patients (38%). The mean duration of VacStent therapy was 8.8 ± 8.3 days. On average, each patient received between one and three VacStents. Technical success was achieved in all 65 cases (100%), while clinical success was observed in 50 patients (77%). Approximately 70% of patients were able to tolerate a liquid diet during treatment, and no major complications were reported.

conclusionsThe VacStent appears as a promising tool, integrating the benefits of both EVT and SEMS, while allowing oral intake. The included studies present preliminary data, warranting cautious interpretation. Further evidence is required to delineate the clinical utility and appropriate indications for VacStent therapy.

trial registrationPROSPERO database (UIN: CRD420251012718).

Indexed as

Anastomotic LeakEsophageal PerforationEsophagoscopyNegative-Pressure Wound TherapySelf Expandable Metallic StentsHumansStentsAnastomotic leakEndoscopic vacuum therapyEsophageal perforationUpper Gastrointestinal tractVacStent

Identifiers

PMID40691570
PMCPMC12278568

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.