Treatment of esophageal leakages with the Microtech®-VAC-Stent: a monocentric early experience of three cases

Michelle A Klose; Jens Walldorf; Marko Damm; Sebastian Krug; Johannes Klose; Ulrich Ronellenfitsch; Joerg Kleeff; Patrick Michl; Jonas Rosendahl

doi:10.1177/26317745231200312

Treatment of esophageal leakages with the Microtech^®-VAC-Stent: a monocentric early experience of three cases

Ther Adv Gastrointest Endosc. 2023 Sep 28:16:26317745231200312. doi: 10.1177/26317745231200312. eCollection 2023 Jan-Dec.

Authors

Michelle A Klose¹, Jens Walldorf¹, Marko Damm¹, Sebastian Krug¹, Johannes Klose², Ulrich Ronellenfitsch², Joerg Kleeff², Patrick Michl¹, Jonas Rosendahl³

Affiliations

¹ Department of Internal Medicine I, Martin-Luther-University Halle-Wittenberg, Saale, Germany.
² Department of General, Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, Saale, Germany.
³ Department of Internal Medicine I, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06120 Halle, Saale, Germany.

Abstract

Background: Endoscopic approaches in the treatment of transmural esophageal defects, either after esophageal resection or due to perforation, have demonstrated convincing feasibility. Surgical options are limited and associated with high morbidity and mortality rates. Currently, internal endoscopic drainage with pigtail stents, self-expanding metal stent (SEMS), or endoscopic vacuum therapy (EVT) are options for first-line treatment. Here, we report the outcome of the recently developed combination of SEMS and EVT using the endoscopic Microtech^®-VAC-Stent (EVS).

Methods: Between June and July 2022, three consecutive patients (one female and two males) with esophageal transmural defects were treated with the Microtech^®-VAC-Stent. Two patients suffered from an anastomotic leak after oncologic gastroesophageal surgery, and one patient presented with esophageal perforation due to Boerhaave syndrome.

Results: Three consecutive patients were successfully treated with EVS. In one patient, one EVS treatment was sufficient, whereas the other two patients needed two and six EVS exchanges. Exchanges were scheduled every 7 days and no procedural adverse events were observed.

Conclusion: In line with the former case series, EVS therapy is a promising new approach for the treatment of esophageal leaks. Exchange of the EVS seems feasible every 7 days reducing interventions for the individual patient. Prospective studies comparing EVS with other endoscopic therapies are needed to define the best therapeutic approach.

Keywords: endoscopic treatment; esophageal leakage; vacuum stent.