AbstractBackground The incidence of esophageal anastomotic leakage and the associated mortality remain significantly high in upper gastrointestinal surgery. Identifying the optimal treatment approach for this often undernourished and clinically compromised patient population continues to pose a major challenge. Methods We report our combined treatment protocol involving stent placement and the concurrent use of a modified intracavitary vacuum therapy in five patients. Results Median duration of endoluminal vacuum therapy was 20 days (range: 18–56), with stents in place for a median of 50 days (range: 37–91); complete closure of the defect was confirmed at stent removal in four patients, and all were discharged with restored swallowing function, while one patient died after hospital discharge from causes unrelated to the leak. Conclusion Our findings indicate that combined endoluminal vacuum therapy and stent placement is a feasible and effective approach for managing anastomotic leakage, even in severely ill patients, providing prompt coverage of the defect and effective drainage of mediastinal fluid collections, while allowing restoration of swallowing function. Due to the small sample size, further studies in larger cohorts are needed to confirm these results.
Herczeg et al. (Wed,) studied this question.