Kouladouros Konstantinos
Central Interdisciplinary Endoscopy, Surgical Clinic, Mannheim University Hospital, University of Heidelberg, Mannheim 68167, Baden-Wuerttemberg, Germany.
World J Gastrointest Endosc. 2023 Jun 16;15(6):420-433. doi: 10.4253/wjge.v15.i6.420.
Endoscopic vacuum therapy (EVT) is an increasingly popular treatment option for wall defects in the upper gastrointestinal tract. After its initial description for the treatment of anastomotic leaks after esophageal and gastric surgery, it was also implemented for a wide range of defects, including acute perforations, duodenal lesions, and postbariatric complications. Apart from the initially proposed handmade sponge inserted using the "piggyback" technique, further devices were used, such as the commercially available EsoSponge and VAC-Stent as well as open-pore film drainage. The reported pressure settings and intervals between the subsequent endoscopic procedures vary greatly, but all available evidence highlights the efficacy of EVT, with high success rates and low morbidity and mortality, so that in many centers it is considered to be a first-line treatment, especially for anastomotic leaks.
内镜下真空治疗（EVT）是治疗上消化道壁缺损日益流行的一种治疗选择。在其最初被描述用于治疗食管和胃手术后的吻合口漏之后，它也被应用于广泛的缺损，包括急性穿孔、十二指肠病变和减重术后并发症。除了最初提出的采用“背驮式”技术插入的手工制作海绵外，还使用了其他装置，如市售的食管海绵和VAC支架以及开孔薄膜引流。报道的后续内镜手术之间的压力设置和间隔差异很大，但所有现有证据都突出了EVT的疗效，成功率高且发病率和死亡率低，因此在许多中心它被认为是一线治疗方法，尤其是对于吻合口漏。
