Gastrointestinal endoscopy · 2026
Efficacy and safety of novel VAC-Stent in management of upper gastrointestinal post-surgical leaks: results from a large multicenter study in tertiary referral centers.
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Zito F P, D'Alessandro A, Dell'Anna G, Martino A, Saviano S, Mandarino F V, Bernardi F, De Leone A, Di Serafino M, Giovine S, Danese S, Rosati R, De Roberto G, Maregatti M, Colace V, Mangiafico S, Donatelli G, Bertani H, Pirozzi F, Esposito D, Giardiello C, Galasso G, Manta R, Lombardi G
Аннотация
BACKGROUND AND AIM: Self-expandable metal stents (SEMS) and endoscopic vacuum therapy (EVT) represent the mainstay of endoscopic treatment for leaks of the upper gastrointestinal (UGI) tract. The VAC-Stent GIᵀᴹ (MicroTech, Düsseldorf, Germany) is a novel device that combines the principles of both SEMS and EVT. In this study, we evaluate the efficacy and safety of VAC-Stent in the management of post-surgical UGI wall defects.
METHODS: A retrospective multicenter study was performed in seven Italian endoscopic centers between June 2023 and January 2025. A total of 81 patients with evidence of UGIpost-surgical leak were enrolled (71.6% male; age range 32 - 83 yrs; mean age 63.5 ± 11.8 yrs). VAC-Stent removal or substitution was scheduled within 7 days from the deployment; continuous suction with negative pressure of - 125 mmHg was applied; leak closure was radiologically and/or endoscopically confirmed.
RESULTS: A total of 156 VAC-Stents GIᵀᴹ was implanted in 81 patients (range 1-7; mean stent per patient 2.0 ± 1.0), with a mean treatment duration of 12.7 ± 6.3 days (range 7 - 41 days). Six out 81 patients were excluded because of premature death unrelated to stent failure. Deployment was successful in 100% of cases (150/150). Mean diameter of the wall defect was 19.6 ± 18.2 mm and complete healing was achieved in 85.3% of patients (64/75). Enteral nutrition was provided in 53.3% of the cases. One case of late bleeding occurred after stent deployment and was managed conservatively; no cases of recurrence were recorded during follow-up.
CONCLUSIONS: VAC-stent GIᵀᴹ represents a safe and effective approach in treating anastomotic leaks following upper GI surgery.
METHODS: A retrospective multicenter study was performed in seven Italian endoscopic centers between June 2023 and January 2025. A total of 81 patients with evidence of UGIpost-surgical leak were enrolled (71.6% male; age range 32 - 83 yrs; mean age 63.5 ± 11.8 yrs). VAC-Stent removal or substitution was scheduled within 7 days from the deployment; continuous suction with negative pressure of - 125 mmHg was applied; leak closure was radiologically and/or endoscopically confirmed.
RESULTS: A total of 156 VAC-Stents GIᵀᴹ was implanted in 81 patients (range 1-7; mean stent per patient 2.0 ± 1.0), with a mean treatment duration of 12.7 ± 6.3 days (range 7 - 41 days). Six out 81 patients were excluded because of premature death unrelated to stent failure. Deployment was successful in 100% of cases (150/150). Mean diameter of the wall defect was 19.6 ± 18.2 mm and complete healing was achieved in 85.3% of patients (64/75). Enteral nutrition was provided in 53.3% of the cases. One case of late bleeding occurred after stent deployment and was managed conservatively; no cases of recurrence were recorded during follow-up.
CONCLUSIONS: VAC-stent GIᵀᴹ represents a safe and effective approach in treating anastomotic leaks following upper GI surgery.