Endoscopic Vacuum Therapy (EVT) in the Management of Postoperative Leaks Following Upper Gastrointestinal Surgery: Case series
Orgilbold E*, Oyudari S, Jungeun K, Odbaatar M, Battsengel B, Taivanbaatar E, Enkhjargal B, Gan-Orshikh L, Batsaikhan N1, Bold A, Enkh-Amgalan Ts
ABSTRACT
Anastomotic leaks and staple line disruptions are among the most serious complications following upper gastrointestinal (GI) surgery, contributing significantly to postoperative morbidity and mortality. This case series describes the clinical application, outcomes, and technical aspects of EVT in patients with postoperative leaks after partial pharyngectomy, gastrectomy, and esophageal diverticulectomy. We retrospectively reviewed three consecutive patients treated with EVT for postoperative leaks between January 2023 and March 2025 at Intermed Hospital. EVT was performed using a polyurethane sponge attached to a nasogastric or nasoesophageal tube, applying continuous negative pressure (−115-125 mmHg) via an external suction device. The patients (2 males, 1 female; mean age 53.4 years) developed leaks after various upper GI procedures, including esophageal diverticulectomy, partial pharyngectomy, and remnant total gastrectomy. EVT duration ranged from 10 to 28 days, with 3 to 8 sponge changes per patient. EVT is an effective and safe treatment for anastomotic leaks after upper GI surgery. It promotes healing, reduces the need for surgical reintervention, and can be successfully applied across a range of postoperative leak scenarios. Early diagnosis, proper sponge positioning, and multidisciplinary care are key to achieving optimal outcomes.
