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EndoVAC在食管癌治疗中解决食管切除术后吻合口漏问题的影响。

The Impact of EndoVAC in Addressing Post-Esophagectomy Anastomotic Leak in Esophageal Cancer Management.

作者信息

Papadakos Stavros P, Argyrou Alexandra, Katsaros Ioannis, Lekakis Vasileios, Mpouga Georgia, Vergadis Chrysovalantis, Fytili Paraskevi, Koutsoumpas Andreas, Schizas Dimitrios

机构信息

Department of Gastroenterology, National and Kapodistrian University of Athens, Laikon General Hospital, 115 27 Athens, Greece.

First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 115 27 Athens, Greece.

出版信息

J Clin Med. 2024 Nov 25;13(23):7113. doi: 10.3390/jcm13237113.

Abstract

Anastomotic leakage (AL) remains a major complication after esophagectomy, especially in patients with esophagogastric cancers who have undergone neoadjuvant therapies, which can impair tissue healing. Endoscopic vacuum-assisted closure (EndoVAC) is an innovative approach aimed at managing AL by facilitating wound drainage, reducing infection, and promoting granulation tissue formation, thus supporting effective healing. This review explores the role and effectiveness of EndoVAC in treating AL post-esophagectomy in esophageal cancer patients. We present an overview of its physiological principles, including wound contraction, enhanced tissue perfusion, and optimized microenvironment, which collectively accelerate wound closure. In addition, we examine clinical outcomes from recent studies, which indicate that EndoVAC is associated with improved leak resolution rates and potentially shorter hospital stays compared to traditional methods. Overall, this review highlights EndoVAC as a promising tool for AL management and underscores the need for continued investigation to refine its protocols and broaden its accessibility. By optimizing EndoVACs use, multidisciplinary teams can improve patient outcomes and advance esophageal cancer care.

摘要

吻合口漏(AL)仍然是食管切除术后的主要并发症,尤其是在接受新辅助治疗的食管癌患者中,新辅助治疗会损害组织愈合。内镜下真空辅助闭合术(EndoVAC)是一种创新方法,旨在通过促进伤口引流、减少感染和促进肉芽组织形成来处理吻合口漏,从而支持有效的愈合。本综述探讨了EndoVAC在治疗食管癌患者食管切除术后吻合口漏中的作用和有效性。我们概述了其生理原理,包括伤口收缩、增强组织灌注和优化微环境,这些共同促进伤口闭合。此外,我们研究了近期研究的临床结果,这些结果表明,与传统方法相比,EndoVAC与更高的漏口愈合率相关,并且可能缩短住院时间。总体而言,本综述强调EndoVAC是处理吻合口漏的一种有前景的工具,并强调需要持续研究以完善其方案并扩大其可及性。通过优化EndoVAC的使用,多学科团队可以改善患者预后并推动食管癌治疗的发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/913f/11642085/fcb1dabcf848/jcm-13-07113-g001.jpg

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