Eso-SPONGE®

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B. Braun Portugal
Eso-SPONGE®

Método minimamente invasivo para tratamento e prevenção de deisciências anastomóticas.

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Eso-SPONGE®
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Eso-SPONGE®
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Eso-SPONGE®
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Eso-SPONGE®
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Eso-SPONGE®
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Eso-SPONGE®

As deiscências anastomóticas são uma das complicações mais temidas após uma esofagectomia, com uma incidência registada de até 30% e alta morbidade e mortalidade associadas.
Diferentes parâmetros, como o tamanho, localização, tempo até ao diagnóstico da lesão, mas também o estado geral do paciente, têm uma influência significativa no resultado clínico do paciente. Muitas vezes, esta situação é acompanhada por sintomas de sépsis e uma significativa taxa de morbidade com uma correspondente taxa de mortalidade substancial.  Por isso o tratamento dessa complicação clínica costuma ser um desafio para os profissionais de saúde.
Após os excelentes resultados obtidos com a terapia Endo-SPONGE® para o trato gastrointestinal inferior. Agora também está disponível a terapia de vácuo endoluminal para o trato gastrointestinal superior – Eso-SPONGE®.
 

Vantagens

  • A terapia a vácuo endoluminal (EVT) é uma abordagem viável, segura e altamente eficiente para tratar deiscências e perfurações anastomóticas no trato gastrointestinal superior. [8-10], [15-34]
  • EVT é utilizada como primeiro método de escolha para deiscências ou perfurações esofágicas já em vários hospitais. [8], [10], [15-31]
  • O tempo médio de duração do tratamento registado é inferior a 30 dias. [8], [9], [16], [20], [24], [29], [36-39]
  • Contribui significativamente para a redução da morbilidade e mortalidade dos pacientes. [8-10], [15-33], [35], [36]
  • Bem tolerado com bons resultados clínicos de curto e longo prazo. [8-10], [15-33], [35], [36]

Nota

*O trato GI superior refere-se ao esófago, estômago e duodeno, acessíveis por via endoscópica através do comprimento do overtube.

Indicação

  • Tratamento de deiscências anastomóticas ou perfurações no trato gastrointestinal superior* através de pressão negativa, incluindo terapia intraluminal ou intracavitária de focos sépticos paraesofágicos e mediastinais ou abscessos localizados acessíveis por via endoscópica.
  • Novo: Terapia preventiva para reduzir o risco de deiscências anastomóticas no trato gastrointestinal superior*.

[1] Bemelman WA, Baron TH. Endoscopic Management of Transmural Defects, Including Leaks, Perforations, and Fistulae. Gastroenterology. 2018 May;154(7):p. 1938-46.e1.

[2] Heits N, Egberts JH, Schniewind B, Hampe J, Becker T, Schafmayer C. Endoscopic-Vacuum-Therapy in Esophgageous Perforations and Anastomotic Leakages after Esophagectomy. The Best Treatment Option to Solve a Major Complication in Upper GI-Surgery? Ann Thorac Surg. 2014 Mar;97(3):1029-35.

[3] Holscher AH, Vallbohmer D, Brabende J. The prevention and management of perioperative complications. Best Pract Res Clin Gastroenterol. 2006;20(5):907-23.

[4] Schaheen L, Blackmon SH, Nason KS, Optimal approach to the management of intrathoracic esophageal leak following esophagectomy: a systematic review. Am J Surg, 2014. 208(4): p. 536-43.

[5] Sdralis EIK, Petousis S, Rashid F, Charalabopoulos A. Epidemiology, diagnosis, and management of esophageal perforations: systematic review. Dis Esophagus. 2017 Aug1;30(8):1-6.

[6] Di Leo M, Maselli R, Ferrara EC, Poliani L, Al Awadhi S, Repici A. Endoscopic Management of Benign Esophageal Ruptures and Leaks. Curr Treat Options Gastroenterol. 2017 Jun;15(2):268-84.

[7] Blencowe NS, Strong S, McNair AG, Brookes ST, Crosby T, Griffin SM, Blazeby JM. Reporting of short-term clinical outcomes after esophagectomy: a systematic review. Ann Surg, 2012 Apr;255(4):658-66.

[8] Kuehn F, Schiffmann L, Janisch F, Schwandner F, Alsfasser G, Gock M, Klar E. Surgical Endoscopic Vacuum Therapy for Defects of the Upper Gastrointestinal Tract. J Gastrointest Surg. 2016 Feb;20(2):237-43.

[9] Heits N, Bernsmeier A, Reichert B, Hauser C, Hendricks A, Seifert D, Richter F, Schafmayer C, Ellrichmann M, Schniewind B, Hampe J, Becker T, Egberts JH. Long-term quality of life after endovac-therapy in anastomotic leakages after esophagectomy. J Thorac Dis. 2018 Jan;10(1):228-40.

[10] Morell B, Murray F, Vetter D, Bueter M, Gubler C. Endoscopic vacuum therapy (EVT) for early infradiaphragmal leakage after bariatric surgery-outcomes of six consecutive cases in a single institution. Langenbecks Arch Surg. 2019 Feb;404(1):115-21.

[11] Kassis ES, Kosinski AS, Ross P Jr, Koppes KE, Donahue JM, Daniel VC. Predictors of anastomotic leak after esophagectomy: an analysis of the society of thoracic surgeons general thoracic database. Ann Thorac Surg. 2013 Dec;96(6):1919-26.

[12] van Rossum PSN, Jeene PM, Rozema T, Braam PM, Lips IM, Muller K, van Kampen D, Vermeulen BD, Homs MYV, Oppedijk V, Berbée M, C C M Hulshof M, Siersema PD, El Sharouni SY. Patient-reported outcomes after external beam radiotherapy versus brachytherapy for palliation of dysphagia in esophageal cancer: a matched comparison of two prospective trials. Radiother Oncol. 2020 Oct 13:S0167-8140(20)30845-8.

[13] Zhang SS, Yang H, Luo KJ, Huang QY, Chen JY, Yang F, Cai XL, Xie X, Liu QW, Bella AE, Hu RG, Wen J, Hu Y, Fu JH. The impact of body mass index on complication and survival in resected oesophageal cancer: a clinical-based cohort and meta-analysis. Br J Cancer. 2013 Nov 26;109(11):2894-903.

[14] Kuehn F, Janisch F, Schwandner F, Alsfasser G, Schiffmann L, Gock M, Klar E. Endoscopic Vacuum Therapy in Colorectal Surgery. J Gastrointest Surg. 2016 Feb;20(2):328-34.

[15] Schniewind B, Schafmayer C, Voehrs G, Egberts J, von Schoenfels W, Rose T, Kurdow R, Arlt A, Ellrichmann M, Jürgensen C, Schreiber S, Becker T, Hampe J. Endoscopic endoluminal vacuum therapy is superior to other regimens in managing anastomotic leakage after esophagectomy: a comparative retrospective study. Surg Endosc. 2013 Oct;27(10):3883-90.

[16] Smallwood NR, Fleshman JW, Leeds SG, Burdick JS. The use of endoluminal vacuum (E-Vac) therapy in the management of upper gastrointestinal leaks and perforations. Surg Endosc. 2016 Jun;30(6):2473-80.

[17] Laukoetter MG, Mennigen R, Neumann PA, Dhayat S, Horst G, Palmes D, Senninger N, Vowinkel T. Successful closure of defects in the upper gastrointestinal tract by endoscopic vacuum therapy (EVT): a prospective cohort study. Surg Endosc. 2017 Jun;31(6):2687-96.

[18] Brangewitz M, Voigtländer T, Helfritz FA, Lankisch TO, Winkler M, Klempnauer J, Manns MP, Schneider AS, Wedemeyer J. Endoscopic closure of esophageal intrathoracic leaks: stent versus endoscopic vacuum-assisted closure, a retrospective analysis. Endoscopy. 2013 Jun;45(6):433-8.

[19] Mennigen R, Harting C, Lindner K, Vowinkel T, Rijcken E, Palmes D, Senninger N, Laukoetter MG. Comparison of Endoscopic Vacuum Therapy Versus Stent for Anastomotic Leak After Esophagectomy. J Gastrointest Surg. 2015 Jul;19(7):1229-35.

[20] Gubler C, Vetter D, Schmidt HM, Müller PC, Morell B, Raptis D, Gutschow CA. Preemptive endoluminal vacuum therapy to reduce anastomotic leakage after esophagectomy: a game-changing approach? Dis Esophagus. 2019 Jul 1;32(7):doy126.

[21] Neumann PA, Mennigen R, Palmes D, Senninger N, Vowinkel T, Laukoetter MG. Pre-emptive endoscopic vacuum therapy for treatment of anastomotic ischemia after esophageal resections. Endoscopy. 2017 May;49(5):498-503.

[22] Möschler O, Nies C, Mueller MK. Endoscopic vacuum therapy for esophageal perforations and leakages. Endosc Int Open. 2015 Dec;3(6):E554-8.

[23] Hwang JJ, Jeong YS, Park YS, Yoon H, Shin CM, Kim N, Lee DH. Comparison of Endoscopic Vacuum Therapy and Endoscopic Stent Implantation With Self-Expandable Metal Stent in Treating Postsurgical Gastroesophageal Leakage. Medicine (Baltimore). 2016 Apr;95(16):e3416.

[24] Bludau M, Fuchs HF, Herbold T, Maus MKH, Alakus H, Popp F, Leers JM, Bruns CJ, Hölscher AH, Schröder W, Chon SH. Results of endoscopic vacuum-assisted closure device for treatment of upper GI leaks. Surg Endosc. 2018 Apr;32(4):1906-14.

[25] Valli PV, Mertens JC, Kröger A, Gubler C, Gutschow C, Schneider PM, Bauerfeind P. Stent-over-sponge (SOS): a novel technique complementing endosponge therapy for foregut leaks and perforations. Endoscopy. 2018 Feb;50(2):148-53.

[26] Rausa E, Asti E, Aiolfi A, Bianco F, Bonitta G, Bonavina L. Comparison of endoscopic vacuum therapy versus endoscopic stenting for esophageal leaks: systematic review and meta-analysis. Dis Esophagus. 2018 Nov 1;31(11).

[27] Pournaras DJ, Hardwick RH, Safranek PM, Sujendran V, Bennett J, Macaulay GD, Hindmarsh A. Endoluminal Vacuum Therapy (E-Vac): A Treatment Option in Oesophagogastric Surgery. World J Surg. 2018 Aug;42(8):2507-11.

[28] Heits N, Stapel L, Reichert B, Schafmayer C, Schniewind B, Becker T, Hampe J, Egberts JH. Endoscopic endoluminal vacuum therapy in esophageal perforation. Ann Thorac Surg. 2014 Mar;97(3):1029-35.

[29] Weidenhagen R, Hartl WH, Gruetzner KU, Eichhorn ME, Spelsberg F, Jauch KW. Anastomotic leakage after esophageal resection: new treatment options by endoluminal vacuum therapy. Ann Thorac Surg. 2010 Nov;90(5):1674-81.

[30] Loske G, Schorsch T, Dahm C, Martens E, Müller C. Iatrogenic perforation of esophagus successfully treated with Endoscopic Vacuum Therapy (EVT). Endosc Int Open. 2015 Dec;3(6):E547-51.

[31] Ooi G, Burton P, Packiyanathan A, Loh D, Chen R, Shaw K, Brown W, Nottle P. Indications and efficacy of endoscopic vacuum-assisted closure therapy for upper gastrointestinal perforations. ANZ J Surg. 2018 Apr;88(4):E257-63.

[32] Alakkari A, Sood R, Everett SM, Rembacken BJ, Hayden J, Sarela A, Mohammed N. First UK experience of endoscopic vacuum therapy for the management of oesophageal perforations and postoperative leaks. Frontline Gastroenterol. 2019 Apr;10(2):200-203.

[33] Chon SH, Toex U, Plum PS, Fuchs C, Kleinert R, Bruns C, Goeser T. Successful closure of a gastropulmonary fistula after esophagectomy using the Apollo Overstitch and endoscopic vacuum therapy. Endoscopy. 2018 Jul; 50(7):E149-50.

[34] Herbold T, Chon SH, Grimminger P, Maus MKH, Schmidt H, Fuchs H, Brinkmann S, Bludau M, Gutschow C, Schröder W, Hölscher AH, Leers JM. Endoscopic Treatment of Transesophageal Echocardiography-Induced Esophageal Perforation. J Laparoendosc Adv Surg Tech A. 2018 Apr;28(4):422-28.

[35] Glatz T, Fischer A, Hoeppner J, Thimme R, Walker C, Richter-Schrag HJ. Vacuum sponge therapy using the pull-through technique via a percutaneous endoscopic gastrostomy to treat iatrogenic duodenal perforation. Endoscopy. 2015;47 Suppl 1:E567-8.

[36] Loske G. Endoscopic negative pressure therapy of the upper gastrointestinal tract. Chirurg. 2019 Jan;90 (Suppl 1):1-6.