Successful closure of esophagogastric anastomotic leak using endoscopic vacuum therapy

A clinical case of a 67-year-old female patient with esophagogastric anastomotic leakage after proximal gastrectomy for cancer of the cardiac portion is presented. The complication manifested itself as acute right-sided pleural empyema on the 12th day after the surgery. After the pleural cavity drainage and primary sanitation of the empyema, endoscopic installation of a vacuum system equipped with an open-pore sponge was chosen as a technique for closing the anastomotic defect. This system was operating for 10 days, gradually reducing the amount of the exudate discharged. There was no need to replace the drainage, since endoscopic examination revealed good regeneration in the area of the anastomotic defect. Intensive therapy, along with drainage and sanitation of sources of inflammation, ensured stabilization of the patient’s general condition and healing of the anastomosis. This clinical observation demonstrates the effectiveness of endoscopic vacuum therapy in treatment of esophageal anastomotic leaks and the prospect of its use in difficult cases associated with defects and fistulas of the gastrointestinal tract.