{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T21:42:31Z","timestamp":1740174151188,"version":"3.37.3"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"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"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Endoscopic vacuum-assisted closure (EVAC) of postsurgical leaks is an increasingly applied technique. Precise intracavitary sponge placement is technically challenging. Here, we describe a novel EVAC therapy using a combined external and endoluminal, pull-through technique.<\/jats:p><jats:p>In this retrospective cohort study, we included all patients treated with pull-through EVAC for post-surgery leaks. During endoscopy, the proximal tip of the percutaneous drainage was visualized within the extraluminal abscess cavity, grasped with forceps, and pulled out orally while maintaining the distal end of the drainage above skin level. A foam sponge was fixed to the tip of the percutaneous drainage and sutured to a gastric tube at the other end. The sponge was placed in the cavity by pulling at the percutaneous drainage. Finally, the gastric probe was channeled nasally and suction was applied. Reinterventions comprised pulling the gastric tube, exchanging the sponge, and re-positioning, as described above. Therapy was stopped after closure or complete epithelialization of the leakage.<\/jats:p><jats:p>Overall, seven patients were included between 2021 and\n        2023. Median duration of pull-through EVAC therapy was 30 days (interquartile range [IQR]\n        11\u201337 days) and the median number of endoscopic interventions was six (IQR 4\u201310). Technical\n        and clinical success was achieved in all (100%) and in six of seven patients (85.7%),\n        respectively. In total, one major bleeding complication associated with EVAC therapy occurred\n        (14.3%).<\/jats:p><jats:p>Pull-through EVAC therapy is safe and effective in patients with large and challenging postsurgical leaks of the upper gastrointestinal tract.<\/jats:p>","DOI":"10.1055\/a-2420-0499","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T23:03:02Z","timestamp":1729897382000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Pull-through endoscopic vacuum-assisted closure therapy for complicated leaks of the gastrointestinal tract: Novel technique"],"prefix":"10.1055","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5251-1422","authenticated-orcid":false,"given":"Carsten","family":"Engelke","sequence":"additional","affiliation":[{"name":"First Department of Medicine, University Hospital Schleswig-Holstein L\u00fcbeck Campus, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaser","family":"Hatem","sequence":"additional","affiliation":[{"name":"First Department of Medicine, University Hospital Schleswig-Holstein L\u00fcbeck Campus, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Maa\u00df","sequence":"additional","affiliation":[{"name":"First Department of Medicine, University Hospital Schleswig-Holstein L\u00fcbeck Campus, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Kraus","sequence":"additional","affiliation":[{"name":"First Department of Medicine, University Hospital Schleswig-Holstein L\u00fcbeck Campus, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Thomaschewski","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Schleswig-Holstein L\u00fcbeck Campus, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabian","family":"Jacob","sequence":"additional","affiliation":[{"name":"Institute for Interventional Radiology, University Hospital Schleswig-Holstein L\u00fcbeck Campus, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Kloeckner","sequence":"additional","affiliation":[{"name":"Institute for Interventional Radiology, University Hospital Schleswig-Holstein L\u00fcbeck Campus, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malte Maria","family":"Sieren","sequence":"additional","affiliation":[{"name":"Institute for Interventional Radiology, University Hospital Schleswig-Holstein L\u00fcbeck Campus, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Keck","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Schleswig-Holstein L\u00fcbeck Campus, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens U","family":"Marquardt","sequence":"additional","affiliation":[{"name":"First Department of Medicine, University Hospital Schleswig-Holstein L\u00fcbeck Campus, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Hoeppner","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital OWL of Bielefeld University Campus Hospital Lippe, Detmold, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha Maria","family":"Kirstein","sequence":"additional","affiliation":[{"name":"First Department of Medicine, University Hospital Schleswig-Holstein L\u00fcbeck Campus, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1007\/s00268-007-9451-2","article-title":"Risk factors and clinical outcome for anastomotic leakage after total mesorectal excision for rectal cancer","volume":"32","author":"W-S Lee","year":"2008","journal-title":"World J Surg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1055\/s-2007-995384","article-title":"Endoscopic transanal vacuum-assisted rectal drainage (ETVARD): an optimized therapy for major leaks from extraperitoneal rectal anastomoses","volume":"40","author":"A Glitsch","year":"2008","journal-title":"Endoscopy"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1080\/00365521.2021.1963836","article-title":"Endoscopic vacuum assisted closure (E-VAC) of upper gastrointestinal leakages","volume":"56","author":"T 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