Evidence map›Paper›PMID 40928642›Full record

ArticleSurgical endoscopy2025

Aortic hemorrhage following anastomotic leakage after esophagogastric surgery before and after implementation of endoscopic vacuum therapy.

Lisanne M D Pattynama, Roos E Pouw, Berrie Meijer, Mark I van Berge Henegouwen, Suzanne S Gisbertz, Kak Khee Yeung, Jacques J Bergman, Wietse J Eshuis

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Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Lisanne M D PattynamaDepartment of Gastroenterology and Hepatology, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Roos E PouwDepartment of Gastroenterology and Hepatology, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. r.e.pouw@amsterdamumc.nl.
Berrie MeijerDijklander Ziekenhuis, Department of Gastroenterology and Hepatology, Maelsonstraat 3, Hoorn, The Netherlands.
Mark I van Berge HenegouwenDepartment of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
Suzanne S GisbertzDepartment of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
Kak Khee YeungAmsterdam UMC Location Vrije Universiteit Amsterdam and Location, Department of Surgery, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.
Jacques J BergmanAmsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands.
Wietse J EshuisDepartment of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndoscopic vacuum therapy (EVT) has been established as a safe and effective treatment for anastomotic leakage. While rare, major aortic hemorrhage has been reported as a severe complication potentially associated with EVT. However, significant hemorrhages have also been observed in patients with transmural defects in the upper gastrointestinal tract, without the use of EVT. This raises questions about the role of EVT as a direct cause of aortic hemorrhage.

methodsThe objective of this study was to further investigate the incidence of major aortic hemorrhage in patients with anastomotic leakage following esophagectomy, both before and after the introduction of EVT. This case series included all patients who experienced an aortic hemorrhage after an anastomotic leak over an 11-year period (January 2013-December 2023). Patients were identified from a prospectively maintained database at Amsterdam UMC and were categorized into two groups: the pre-EVT period and the EVT period.

resultsIn the pre-EVT period, 355 patients underwent a transthoracic esophagectomy, with 62 (17%) developing anastomotic leakage. In the EVT period, 527 patients underwent the same procedure, with 83 (16%) anastomotic leakages. A total of 7 patients developed a major aortic hemorrhage: 5 in the pre-EVT period (12%) and 2 in the EVT period (2%).

conclusionAlthough EVT has been proposed in literature as a potential cause of major aortic hemorrhage, our findings provide a more nuanced perspective. In this cohort, aortic hemorrhages tend to occur in case of severe mediastinitis, also without treatment with EVT.

Indexed as

Anastomotic LeakAortic DiseasesEsophagectomyNegative-Pressure Wound TherapyPostoperative HemorrhageAgedFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesAnastomotic leakageAortic hemorrhageEndoscopic vacuum therapyEsophagectomy

Identifiers

PMID40928642
PMCPMC12500753

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