Monino Laurent, Moreels Tom G
Department of Gastroenterology & Hepatology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, B-1200 Brussels, Belgium.
Life (Basel). 2023 Jun 19;13(6):1412. doi: 10.3390/life13061412.
Anastomotic leaks after gastrointestinal surgery have an important impact on surgical outcomes because of the high morbidity and mortality rates. Multiple treatment options exist requiring an individualized patient-tailored treatment plan after multidisciplinary discussion. Endoscopic vacuum therapy (EVT) is a novel treatment option that is nowadays recognized as an effective and useful endoscopic approach to treat leaks or perforations in both the upper and lower gastrointestinal tract. EVT has a very good safety profile. However, it is a time-consuming endeavour requiring engagement from the endoscopist and understanding from the patient. To the unexperienced, the EVT technique may be prone to several hurdles which may deter endoscopists from using it and depriving patients from a potentially life-saving therapeutic option. The current review highlights the possible difficulties of the EVT procedure and aims to provide some practical solutions to facilitate its use in daily clinical practice. Personal tips and tricks are shared to overcome the pre-, intra- and post-procedural hurdles. An instructive video of the procedure helps to illustrate the technique of EVT.
胃肠手术后的吻合口漏由于其高发病率和死亡率,对外科手术结果有重要影响。存在多种治疗选择,需要在多学科讨论后制定个体化的患者定制治疗方案。内镜下真空治疗(EVT)是一种新型治疗选择,如今被认为是治疗上、下消化道漏或穿孔的一种有效且有用的内镜方法。EVT具有非常好的安全性。然而,这是一项耗时的工作,需要内镜医师的参与以及患者的理解。对于没有经验的人来说,EVT技术可能容易遇到几个障碍,这可能会阻碍内镜医师使用它,使患者失去一种可能挽救生命的治疗选择。本综述强调了EVT操作可能存在的困难,旨在提供一些实用的解决方案,以促进其在日常临床实践中的应用。分享了个人的技巧和窍门,以克服术前、术中和术后的障碍。一段该操作的指导性视频有助于说明EVT技术。