JPGN Rep

. 2023 Apr 26;4(2):e314.

 doi: 10.1097/PG9.0000000000000314. eCollection 2023 May. https://pubmed.ncbi.nlm.nih.gov/37200717/

Treatment of Esophageal Perforation: Endoscopic Vacuum-Assisted Closure

Grafton S Barnett ¹, Kathryn M Kimsey ¹, Hester F Shieh ², C Jason Smithers ², Jonathan M de Vries ¹, Jack Mouch ¹, Michael Wilsey ¹

Affiliations expand

• PMID: 37200717
• PMCID: PMC10187847
• DOI: 10.1097/PG9.0000000000000314

Free PMC article

Abstract

Surgical repair of type C esophageal atresia (EA) with distal tracheoesophageal fistula (TEF) is complicated by an anastomotic leak in 10%-30% of cases with associated morbidity. A novel procedure in the pediatric population, endoscopic vacuum-assisted closure (EVAC), accelerates the healing of esophageal leaks by using the effects of VAC therapy, including fluid removal and stimulation of granulation tissue formation. We report 2 additional cases of chronic esophageal leak treated with EVAC in EA patients. The first is a patient with a previously repaired type C EA/TEF and left congenital diaphragmatic hernia complicated by an infected diaphragmatic hernia patch erosion into the esophagus and colon. Additionally, we discuss a second case using EVAC for early anastomotic leak following type C EA/TEF repair in a patient who was later found to have a distal congenital esophageal stricture.

Keywords: anastomosis; hernia; pediatrics; sponge; tracheoesophageal fistula.

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.