Research: Treatment of Esophageal Perforation: Endoscopic Vacuum-Assisted Closure


. 2023 Apr 26;4(2):e314.

 doi: 10.1097/PG9.0000000000000314. eCollection 2023 May.

Treatment of Esophageal Perforation: Endoscopic Vacuum-Assisted Closure

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

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Free PMC article


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.

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