Eso-Sponge® for anastomotic leakage after oesophageal resection or perforation: outcomes from a national, prospective multicentre registry

Florian Richter, Alexander Hendricks, Bodo Schniewind, Jochen Hampe, Nils Heits, Witigo von Schönfels, Benedikt Reichert, Katrin Eberle, Mark Ellrichmann, Petra Baumann, Jan-Hendrik Egberts, Thomas Becker, Clemens Schafmayer, Florian Richter, Alexander Hendricks, Bodo Schniewind, Jochen Hampe, Nils Heits, Witigo von Schönfels, Benedikt Reichert, Katrin Eberle, Mark Ellrichmann, Petra Baumann, Jan-Hendrik Egberts, Thomas Becker, Clemens Schafmayer

Abstract

Background: Anastomotic leakage (AL) after oesophagectomy and oesophageal perforations are associated with significant morbidity and mortality. Minimally invasive endoscopy is often used as first-line treatment, particularly endoluminal vacuum therapy (EVT). The aim was to assess the performance of the first commercially available endoluminal vacuum device (Eso-Sponge®) in the management of AL and perforation of the upper gastrointestinal tract (GIT).

Methods: The Eso-Sponge® registry was designed in 2014 as a prospective, observational, national, multicentre registry. Patients were recruited with either AL or perforation within the upper GIT. Data were collected with a standardized form and transferred into a web-based platform. Twenty hospitals were enrolled at the beginning of the study (registration number NCT02662777; http://www.clinicaltrials.gov). The primary endpoint was successful closure of the oesophageal defect.

Results: Eleven out of 20 centres recruited patients. A total of 102 patients were included in this interim analysis; 69 patients with AL and 33 with a perforation were treated by EVT. In the AL group, a closure of 91 per cent was observed and 76 per cent was observed in the perforation group. The occurrence of mediastinitis (P = 0.002) and the location of the defect (P = 0.008) were identified as significant predictors of defect closure.

Conclusions: The Eso-Sponge® registry offers the opportunity to collate data on EVT with a uniform, commercially available product to improve standardization. Our data show that EVT with the Eso-Sponge® is an option for the management of AL and perforation within the upper GIT.

© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.

Figures

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Endoscopic vacuum therapy
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Fig. 2
Endoscopic vacuum therapy

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Source: PubMed

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