Vacuum Therapy of an Esophageal Anastomotic Leakage - A Case Report

Background: Esophageal anastomotic leakage is a major complication. In rectal surgery, anastomotic dehiscence is successfully treated by endoscopically placed intracavitary vacuum sponge systems. We used this technique in a case of anastomotic dehiscence following transhiatal gastrectomy. Patient and Method: In an 80-year-old female patient esophageal anastomotic leakage was diagnosed endoscopically six days following transhiatal gastrectomy. Endocavitary treatment by endoscopic implantation of a vacuum sponge system was performed. After 14 days of treatment with 4 system changes and a change interval of 2-4 days complete healing was observed. A week later, a second wall defect was diagnosed and treated in the same way. The total hospital stay after operation was sixty days. Conclusion: Esophageal anastomotic leakage can be successfully treated by means of an endoscopically placed intracavitary vacuum sponge system. This paper describes the therapeutic technique.