126 VACStent Closure of Oesphageal Defects by Covered Stent and Endoscopic Vacuumtherapy: Initial Use and Clinical Outcomes

Abstract Background Endoscopic management of transmural oesophageal defects—such as those post-oesophagectomy or due to Boerhaave’s syndrome—is often limited by stent migration and luminal occlusion. The VACStent is a novel device combining a fully covered intestinal stent within a polyurethane sponge, integrating endoscopic vacuum therapy (EVT) to enable drainage and promote wound healing. We report our initial experience using this technology. Method Between February 2023 and April 2024, four patients with oesophageal defects were treated with the VACStent (two with post-oesophagectomy staple line leaks and two with Boerhaave’s syndrome). The procedure involved endoscopic stent placement under general anaesthesia, followed by scheduled endoscopic evaluations and stent exchanges every six days. Results All four patients achieved successful defect closure. Three required only one VACStent application, while one needed two. No complications—such as bleeding, mucosal erosion, stent migration, or post-treatment stenosis—were observed. Oral intake was resumed after confirmation of closure via gastrografin contrast study. Conclusions VACStent therapy is a promising, safe, and effective modality for managing transmural oesophageal defects. It’s encouraging clinical and endoscopic outcomes suggest it may become a new standard in endoscopic care for such cases.