title: Endoscopic vacuum therapy of anastomotic leakage and iatrogenic perforation in the esophagus.
abstract: BACKGROUND
  The management of anastomotic leakage and iatrogenic esophageal perforation has shifted over recent decades from aggressive surgery to conservative and, recently, endoscopic therapy alternatives. The authors present their results for endoscopic vacuum therapy used to treat both entities.
  
  
  METHODS
  In the authors' institution, 17 cases of anastomotic leakage and 7 cases of iatrogenic perforation due to interventional endoscopy or rigid panendoscopy with either intraluminal or intracavitary endoscopic vacuum therapy were treated.
  
  
  RESULTS
  In 23 of 24 cases, the endoscopic treatment was successful. The median duration of therapy was 11 days (range, 4-46 days). All 7 cases of iatrogenic perforation and 16 of 17 anastomotic leakage cases were cured after a median therapy duration of 5 and 12 days, respectively.
  
  
  CONCLUSIONS
  Endoscopic vacuum therapy is applicable for a wide range of esophageal defects. In the authors' experience, it has seemed to be the best choice for iatrogenic perforations and has been a potent supplement in the management of anastomotic leakages.
authors.affiliation: Department for General, Abdominal, Thoracic, and Vascular Surgery, Katholisches Marienkrankenhaus Hamburg gGmbH, Alfredstrasse 9, 22087, Hamburg, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Schorsch
authors.forename: Christian
authors.initials: C
authors.lastname: Müller
authors.forename: Gunnar
authors.initials: G
authors.lastname: Loske
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000628:therapy*; D004724:Endoscopy / Q000379:methods*; D004939:Esophageal Perforation / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*