Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy

Endoscopic vacuum therapy (EVT) offers an effective alternative for the treatment of anastomotic leakage. Current treatment options for leakage include conservative treatment, stent placement, or reoperation. However, conservative treatment often results in slow recovery and is frequently ineffective in severe cases. Stent placement carries risks such as migration or blockage, and both conservative treatment and stents often fail to adequately drain pus or necrotic tissue exudate. Moreover, reoperation is associated with a high risk of surgical complications. EVT employs continuous negative pressure to remove pus and necrotic tissue exudate through natural orifices. This approach also promotes granulation tissue formation at the fistula or leakage site, facilitating the healing process. Clinically, EVT has demonstrated the potential to significantly reduce complications such as infection, bleeding, and anastomotic stenosis. It not only improves patient's outcomes but also minimizes the need for additional invasive procedures and shortens hospital stays. In conclusion, EVT represents a promising and innovative approach for managing complex gastrointestinal leaks.