Endoscopic vacuum therapy in the treatment of anastomotic incompetence in the upper digestive tract: the first experience and a review of the literature

Surgery for the upper digestive tract is justly a high-risk one and is absolutely associated with the development of severe, life-threatening complications, particularly incompetent digestive anastomoses, which in turn lead to pyoseptic complications. After extensive surgical interventions into the esophagus and stomach, the mortality rates from anastomotic incompetence are as high as 60%. There is a steady decline in the number of complications due to the accumulation of experience and improvement of surgical techniques. Endoscopic techniques for the closure of perforation are priority since they result in lower mortality rates.

The paper describes the experience in treating 6 patients (after laparoscopic proximal gastric resection (n = 4), gastrectomy (n = 1), and longitudinal gastric resection (n = 1)), by using a vacuum aspiration system, in the period from March to December 2015. It shows a procedure for installing the vacuum aspiration system and its mechanism of action, gives the obtained results of this procedure, and analyzes the experience of world literature. 

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