title: Endoluminal Vacuum Therapy for Ivor Lewis Anastomotic Leaks: A Pilot Study in a Swine Model.
abstract: Anastomotic leaks are a serious complication associated with Ivor Lewis esophagectomies. Endoluminal negative pressure vacuum devices create a possible treatment alternative to conventional surgical intervention. Ten pigs had an intrathoracic esophageal anastomosis with a 1-cm defect. The experimental group had the device placed intraoperatively across the defect, whereas the control group did not. Once treatment was completed, a contrast fluoroscopic study and necropsy was performed. All control pigs had contrast extravasation on fluoroscopy and contamination on necropsy. The experimental group had no radiologic leak and no contamination on necropsy. The P value for leak is 0.03. This study demonstrated that endoluminal negative pressure vacuum therapy is tolerated in the swine model and is successful in facilitating the healing of anastomotic leaks. Endoluminal negative pressure vacuum therapy has potential clinical benefits, including decreased morbidity and length of hospital stay.
authors.affiliation: Department of Surgery, Western Connecticut Health System, Danbury, Connecticut, USA.
authors.forename: R B
authors.initials: RB
authors.lastname: Scott
authors.affiliation: Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Ritter
authors.affiliation: Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Shada
authors.affiliation: Center for Comparative Medicine, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Feldman
authors.affiliation: Department of Surgery, Western Connecticut Health System, Danbury, Connecticut, USA.
authors.forename: D E
authors.initials: DE
authors.lastname: Kleiner
mesh_terms: D057868:Anastomotic Leak / Q000628:therapy*; D000818:Animals; D004195:Disease Models, Animal; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology; D005471:Fluoroscopy; D010865:Pilot Projects; D013552:Swine; D014618:Vacuum