The Eso-SPONGE® therapy for the treatment of anastomotic leakage after esophageal surgery .
EAES Academy. Fortuna L. 07/05/22; 363160; P205
Dr. Laura Fortuna
Contributions
Contributions
Abstract
Aim:
anastomotic leakage after surgery for esophageal cancer represents a potentially lethal complication and it’s treatment remains challenging. Endoscopic debridement followed by the positioning of Eso-SPONGE® therapy can be an effective technique even for multiple, thoracic and mediastinal contaminations after dehiscence of intrathoracic esophagogastric anastomosis in appropriately selected patients.
Methods:
we present two cases: a 61-years old woman with squamous esophageal cancer who underwent total robotic esophagectomy and a 65-years old man with esophageal adenocarcinoma treated with mini-invasive Ivor–Lewis esophagectomy.
On 12th and e 13th postoperative day respectively, both patients exhibited fever and dyspnoea, therefore a CT scan was conducted showing anastomotic leakage. The initial treatment with intravenous antibiotics was started but as clinical conditions failed to improve, they were referred for endovac therapy (EVT). The initial size of the wound was 1,5 x 2cm and 4 x 2,5cm, respectively. After the debridement and aspiration of corpuscular liquid, the Eso-SPONGE® was positioned. The device was replaced every 3-4 day in both patients.
Results:
a complete recovery was achieved in both patients. The Eso-SPONGE® therapy was successful from the very first moments. The mean duration of EVT was 28 days, with 4 and 7 sessions respectively. Mortality was 0%. The mean follow up was six months showing no complication.
Conclusion:
anastomotic leaks can have functional and oncological consequences. The treatment can also affect the general and oncological outcomes. Several strategies have been applied in its management and the Eso-SPONGE® has proven to be a minimally invasive method which offers excellent results especially in the treatment of the most fragile patients. This technique is well tolerated, feasible and effective and has shown the potential to significantly reduce morbidity and mortality. In both cases presented by us, further surgery was avoided.
anastomotic leakage after surgery for esophageal cancer represents a potentially lethal complication and it’s treatment remains challenging. Endoscopic debridement followed by the positioning of Eso-SPONGE® therapy can be an effective technique even for multiple, thoracic and mediastinal contaminations after dehiscence of intrathoracic esophagogastric anastomosis in appropriately selected patients.
Methods:
we present two cases: a 61-years old woman with squamous esophageal cancer who underwent total robotic esophagectomy and a 65-years old man with esophageal adenocarcinoma treated with mini-invasive Ivor–Lewis esophagectomy.
On 12th and e 13th postoperative day respectively, both patients exhibited fever and dyspnoea, therefore a CT scan was conducted showing anastomotic leakage. The initial treatment with intravenous antibiotics was started but as clinical conditions failed to improve, they were referred for endovac therapy (EVT). The initial size of the wound was 1,5 x 2cm and 4 x 2,5cm, respectively. After the debridement and aspiration of corpuscular liquid, the Eso-SPONGE® was positioned. The device was replaced every 3-4 day in both patients.
Results:
a complete recovery was achieved in both patients. The Eso-SPONGE® therapy was successful from the very first moments. The mean duration of EVT was 28 days, with 4 and 7 sessions respectively. Mortality was 0%. The mean follow up was six months showing no complication.
Conclusion:
anastomotic leaks can have functional and oncological consequences. The treatment can also affect the general and oncological outcomes. Several strategies have been applied in its management and the Eso-SPONGE® has proven to be a minimally invasive method which offers excellent results especially in the treatment of the most fragile patients. This technique is well tolerated, feasible and effective and has shown the potential to significantly reduce morbidity and mortality. In both cases presented by us, further surgery was avoided.
Aim:
anastomotic leakage after surgery for esophageal cancer represents a potentially lethal complication and it’s treatment remains challenging. Endoscopic debridement followed by the positioning of Eso-SPONGE® therapy can be an effective technique even for multiple, thoracic and mediastinal contaminations after dehiscence of intrathoracic esophagogastric anastomosis in appropriately selected patients.
Methods:
we present two cases: a 61-years old woman with squamous esophageal cancer who underwent total robotic esophagectomy and a 65-years old man with esophageal adenocarcinoma treated with mini-invasive Ivor–Lewis esophagectomy.
On 12th and e 13th postoperative day respectively, both patients exhibited fever and dyspnoea, therefore a CT scan was conducted showing anastomotic leakage. The initial treatment with intravenous antibiotics was started but as clinical conditions failed to improve, they were referred for endovac therapy (EVT). The initial size of the wound was 1,5 x 2cm and 4 x 2,5cm, respectively. After the debridement and aspiration of corpuscular liquid, the Eso-SPONGE® was positioned. The device was replaced every 3-4 day in both patients.
Results:
a complete recovery was achieved in both patients. The Eso-SPONGE® therapy was successful from the very first moments. The mean duration of EVT was 28 days, with 4 and 7 sessions respectively. Mortality was 0%. The mean follow up was six months showing no complication.
Conclusion:
anastomotic leaks can have functional and oncological consequences. The treatment can also affect the general and oncological outcomes. Several strategies have been applied in its management and the Eso-SPONGE® has proven to be a minimally invasive method which offers excellent results especially in the treatment of the most fragile patients. This technique is well tolerated, feasible and effective and has shown the potential to significantly reduce morbidity and mortality. In both cases presented by us, further surgery was avoided.
anastomotic leakage after surgery for esophageal cancer represents a potentially lethal complication and it’s treatment remains challenging. Endoscopic debridement followed by the positioning of Eso-SPONGE® therapy can be an effective technique even for multiple, thoracic and mediastinal contaminations after dehiscence of intrathoracic esophagogastric anastomosis in appropriately selected patients.
Methods:
we present two cases: a 61-years old woman with squamous esophageal cancer who underwent total robotic esophagectomy and a 65-years old man with esophageal adenocarcinoma treated with mini-invasive Ivor–Lewis esophagectomy.
On 12th and e 13th postoperative day respectively, both patients exhibited fever and dyspnoea, therefore a CT scan was conducted showing anastomotic leakage. The initial treatment with intravenous antibiotics was started but as clinical conditions failed to improve, they were referred for endovac therapy (EVT). The initial size of the wound was 1,5 x 2cm and 4 x 2,5cm, respectively. After the debridement and aspiration of corpuscular liquid, the Eso-SPONGE® was positioned. The device was replaced every 3-4 day in both patients.
Results:
a complete recovery was achieved in both patients. The Eso-SPONGE® therapy was successful from the very first moments. The mean duration of EVT was 28 days, with 4 and 7 sessions respectively. Mortality was 0%. The mean follow up was six months showing no complication.
Conclusion:
anastomotic leaks can have functional and oncological consequences. The treatment can also affect the general and oncological outcomes. Several strategies have been applied in its management and the Eso-SPONGE® has proven to be a minimally invasive method which offers excellent results especially in the treatment of the most fragile patients. This technique is well tolerated, feasible and effective and has shown the potential to significantly reduce morbidity and mortality. In both cases presented by us, further surgery was avoided.
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