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Endoluminale Vakuum-Therapie zur Behandlung der Anastomoseninsuffizienz des oberen GI-Traktes

Eine Nahtinsuffizienz der Anastomose oder andere Leckagen am oberen Gastrointestinaltrakt können schwerwiegende Folgen für die betroffenen Patienten haben. Verschiedene Parameter, wie die Größe, die Lokalisation, die Latenzzeit bis zur Diagnosestellung der Läsion, aber auch der Allgemeinzustand des Patienten haben einen erheblichen Einfluss auf den klinischen Verlauf.
Häufig geht diese Befundkonstellation mit einem septischen Krankheitsbild einher, und in schweren Fällen ist eine relevante Morbiditätsrate mit entsprechender Mortalität die Folge.

Eso-SPONGE® ist ein innovatives Therapiekonzept, welches erheblich zur Verringerung der Morbidität und Mortalität der Patienten beiträgt [4, 17-21, 26-31, 33-41, 46, 47, 49]

Die Insuffizienzhöhle wird durch das endoskopisch eingebrachte Schwammsystem Eso-SPONGE® mit Anschluss an eine regelbare, medizinische Pumpe drainiert. Durch die offenen Poren des Schwammes wir der Sog gleichmäßig auf das gesamte mit der Oberfläche des Schwammes in Kontakt stehende Gewebe übertragen.

Vorteile

  • Kontinuierliche Drainage, kein Sekretstau [4,5, 9, 18, 19, 21, 29 34, 35, 46, 47,49]
  • Infektkontrolle [4,5, 9, 18, 19, 21, 29 34, 35, 46, 47,49]
  • Debridement, rasche Säuberung der Wundhöhle [4,5, 9, 18, 19, 21, 29 34, 35, 46, 47,49]
  • Granulationsförderung [4,5, 9, 18, 19, 21, 29 34, 35, 46, 47,49]
  • Mechanische Verkleinerung der Wundhöhle [4,5, 9, 18, 19, 21, 29 34, 35, 46, 47,49
  • Erfolgreicher Verschluss der Leckage oder Perforation bei 95% der Patienten (77.9 - 100%) [18, 19, 29, 34, 46-48] [49] [21] [35]
  • Gut verträglich mit guten kurz- und langfristigem klinischen Ergebnis [4, 17-21, 26-31, 33-41, 46, 47, 49]
  • Behandlungsdauer ca. 1 bis 30 Tage [18, 19, 21, 29, 34, 35 46-48, 49]
  • Kann mit enteraler Ernährung kombiniert werden [18, 29, 34, 46-48]
  • Scheint der Stent Behandlung überlegen zu sein, weniger chirurgische Revision und weniger Strikturen [17, 21, 27, 28, 33-36]

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47. Chon, S.-H., et al., Successful closure of a gastropulmonary fistula after esophagectomy using the Apollo Overstitch and endoscopic vacuum therapy. Endoscopy, 2018. 50(07): p. E149-E150.

48. Glatz, T., et al., Vacuum sponge therapy using the pull-through technique via a percutaneous endoscopic gastrostomy to treat iatrogenic duodenal perforation. Endoscopy, 2015. 47 Suppl 1: p. E567-8.

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