FIRST EXPERIENCE OF USING ENDOSCOPIC VACUUM-ASSISTED AND ASPIRATION THERAPY IN THE TREATMENT OF SPONTANEOUS RUPTURE OF THE ESOPHAGUS (BOERHAAVE SYNDROME)

Abstract

The aim of the article is to demonstrate the possibilities of minimally invasive surgery in the treatment of spontaneous rupture of the esophagus (Boerhaave syndrome). Within the last 10 years endoscopic treatment has changed the approach to the esophageal rupture treatment. Implantation of fully-covered self-expanding metal or plastic stents is the most extensively studied endoscopic method, and it has proven to be effective in 67-100 % of cases. The successful closure of esophageal rupture by endoscopic placement of a vacuum sponge (endoscopic vacuum assisted closure (E-VAC)) has recently been reported. Vacuum-assisted closure (VAC) is an established treatment modality for extensive cutaneous infected wounds. This principle has been adapted to the treatment of endoscopically accessible upper gastrointestinal leakages by endoscopic placing of sponges connected with a drainage tube in the necrotic cavities (E-VAC).

Keywords

• boerhaave syndrome
• spontaneous rupture of the esophagus
• endoscopic vacuum therapy
• mediastinitis