Comparison of Endoscopic Vacuum Therapy and Endoscopic Stent Implantation with Self-Expandable Metal Stent in Treating Postsurgical esophageal anastomotic

Introduction: Esophageal anastomotic leak leads to high mortality rate and it is considered as a reason that disimproves the quality of life. According to the data showing high prevalence of this disease, some endoscopic methods or at least invasion methods such as endoscopic implantation with self-expandable metal stent (E-SEMS) are supported and introduced. This study aims to compare the results of EVT and E-SMES in treating postsurgical esophageal anastomotic leaks.Methodology: For literature review, some keywords were used for searching on the internet, separately and in combination, such as endoscopic vacuum therapy, esophageal anastomotic leakage, E-SMES, esophagus surgery, both in Persian and English. This research has been done from 2010 to 2019 and some data bases were used including SCOPUS, ISC, PUBMED, OVIS, and SIENCE DIRECT. Finally, according to the study purpose, 8 related essays were considered and analyzed.Findings: According to the researches, E-SEMS side effects are movement problems, difficulty in resection because of tissue growth and tissue stiffness, after the tissue is resected. In between, EVT as a modern method, needs less restoration and recovery time, there is no need to repeat the surgery, narrowing of the esophagus will not happen, the cutting position in surgery will be cleaned more efficiently and as a result the possibility of infection is reduced and the possibility of sepsis because of continuous negative pressure is low. Moreover, this method leads to increase veins perfusion and it strengthens the granulation tissue in the restoration procedure. One of the reported advantages in this method is that general anesthesia is not necessary. The main disadvantage of ETV method is using endoscopy procedure repeatedly at the time of vacuum placement.Discussion and Conclusion: Our findings show that comparing to E-SEMS, in EVT method the rate of patients recovery is higher and the rate of death because of infection and side effects related to this procedure is less than the other method. This procedure can be the first method of treatment and it can be used as a lifesaving method, when it comes to managing similar clinical conditions. Considering the quantitative limitation on having related studies on this subject and the purposes of this study, it is recommended to researchers to study and research more on this subject.

Keywords:

Endoscopic Vacuum Therapy , E-SMES , esophageal anastomotic leakage