{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T10:44:15Z","timestamp":1786704255227,"version":"build-2736575974"},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T00:00:00Z","timestamp":1622073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002Endoscopic treatment has markedly improved the high morbidity and mortality in patients with upper gastrointestinal tract leakage. Most procedures employ either covered self-expanding metal stents (SEMS) or endoscopic vacuum therapy (EVT), both with good clinical success but also with concomitant significant shortcomings inherent in each technique. A newly developed device, the VACStent, combines the fully covered SEMS with a polyurethane sponge cylinder anchored on the outside. This allows endoluminal EVT while keeping the intestinal lumen patent. The benefit is prevention of stent migration because the suction force of the sponge-cylinder immobilizes the VACStent on the intestinal wall, while at the same time, the attached external vacuum pump suctions off any secretions and improves healing with negative-pressure wound treatment (NPWT).<\/jats:p><jats:p>\n          Patients and methods\u2002In this pilot study, the first patients to receive the VACStent were assessed. Outcomes included the applicability and stability of the VACStent system together with the clinical course.<\/jats:p><jats:p>\n          Results\u2002Three patients with different clinical courses were managed with the VACStent. The first patient suffered anastomotic leakage following subtotal esophagectomy and was successfully treated with two postoperative VACStents for 12 days. The second patient received a covered SEMS for 14 days for acute Boerhaave syndrome. Due to persistent leakage, management was converted to EVT. Seven days, later a VACStent was inserted to allow oral nutrition while the leak finally closed. In the third patient, a LINX Reflux Management System had to be removed for erosion, leaving the gastroesophageal junction (GEJ) with a full-thickness gap.\u200aAfter VACstent insertion, successful closure was achieved within 4 days.<\/jats:p><jats:p>\n          Conclusions\u2002These clinical cases demonstrate the applicability and efficacy of the VACstent in management of esophageal and anastomotic leakage. With its vacuum sponge, the stent fosters wound healing while the covered SEMS keeps the passage patent for nutrition.<\/jats:p>","DOI":"10.1055\/a-1474-9932","type":"journal-article","created":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T23:16:28Z","timestamp":1622157388000},"page":"E971-E976","source":"Crossref","is-referenced-by-count":46,"title":["VACStent: Combining the benefits of endoscopic vacuum therapy and covered stents for upper gastrointestinal tract leakage"],"prefix":"10.1055","volume":"09","author":[{"given":"Jonas","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Abdominal, Tumor, Transplant and Vascular Surgery, Cologne-Merheim Medical Center, University Witten\/Herdecke, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arno","family":"Dormann","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Cologne-Holweide and Merheim Medical Center, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk Rolf","family":"Bulian","sequence":"additional","affiliation":[{"name":"Department of Abdominal, Tumor, Transplant and Vascular Surgery, Cologne-Merheim Medical Center, University Witten\/Herdecke, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"H\u00fcgle","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Cologne-Holweide and Merheim Medical Center, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus Ferdinand","family":"Eisenberger","sequence":"additional","affiliation":[{"name":"Department of Abdominal, Tumor, Transplant and Vascular Surgery, Cologne-Merheim Medical Center, University Witten\/Herdecke, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus Maria","family":"Heiss","sequence":"additional","affiliation":[{"name":"Department of Abdominal, Tumor, Transplant and Vascular Surgery, Cologne-Merheim Medical Center, University Witten\/Herdecke, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,5,27]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1055\/s-0034-1377531","article-title":"Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement","volume":"46","author":"G A Paspatis","year":"2014","journal-title":"Endoscopy"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"E1671","DOI":"10.1055\/a-1005-6632","article-title":"International multicenter expert survey on endoscopic treatment of upper gastrointestinal anastomotic leaks","volume":"7","author":"E Rodrigues-Pinto","year":"2019","journal-title":"Endosc Int 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negative pressure for treating chronic wounds","volume":"3","author":"D T Ubbink","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1097\/00000637-199706000-00001","article-title":"Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation","volume":"38","author":"M J Morykwas","year":"1997","journal-title":"Ann Plast Surg"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"E64","DOI":"10.1055\/s-0030-1255799","article-title":"Ingrowth and device disintegration in an intralobar abscess cavity during endosponge therapy for esophageal anastomotic leakage","volume":"43","author":"B Schniewind","year":"2011","journal-title":"Endoscopy"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"3449","DOI":"10.1007\/s00464-016-5404-x","article-title":"Endoscopic vacuum therapy for various defects of the upper gastrointestinal tract","volume":"31","author":"F Kuehn","year":"2017","journal-title":"Surg Endosc"}],"container-title":["Endoscopy International 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