中国普通外科杂志2026，Vol.35Issue(4)：721-728,8.DOI:10.7659/j.issn.1005-6947.260106
腔内负压辅助闭合技术治疗食管空肠吻合口漏的疗效与安全性:21例回顾性分析(附视频)
Efficacy and safety of endoluminal vacuum-assisted closure for esophagojejunal anastomotic leakage:a retrospective analysis of 21 cases(with video)
摘要
Abstract
Background and Aims:Esophagojejunal anastomotic leakage is one of the most severe complications after total gastrectomy and may lead to intra-abdominal or mediastinal infection with high mortality.Endoluminal vacuum-assisted closure(EVAC)has recently emerged as a minimally invasive treatment for gastrointestinal leaks;however,evidence regarding its application in esophagojejunal anastomotic leakage remains limited.This study aimed to evaluate the efficacy and safety of EVAC in the treatment of esophagojejunal anastomotic leakage. Methods:Clinical data of 21 patients with esophagojejunal anastomotic leakage treated with EVAC at Jiangyin People's Hospital between January 2022 and July 2025 were retrospectively analyzed.All patients were diagnosed by endoscopy or imaging examinations and underwent placement of a self-made EVAC device under endoscopic guidance.Technical success rate,fistula closure rate,duration of EVAC therapy,healing time,length of hospital stay,changes in inflammatory markers,treatment-related complications,and long-term outcomes were evaluated. Results:All 21 patients successfully underwent EVAC placement and negative-pressure therapy,with a technical success rate of 100%.Fistula closure was achieved in 18 patients,yielding a closure rate of 85.7%.The mean duration of EVAC therapy was(15.8±8.2)d,and the mean healing time was(19.1±9.4)d.The median postoperative hospital stay was 27(25-49)d.White blood cell count and C-reactive protein levels were significantly reduced after treatment compared with pre-treatment values(both P<0.05).No severe treatment-related complications,including major gastrointestinal bleeding,stenosis,or foreign body retention,were observed.During a mean follow-up of(22.4±12.6)months,no recurrence of anastomotic leakage,gastrointestinal stenosis,or newly developed abscess was detected. Conclusion:EVAC is an effective and safe minimally invasive treatment for esophagojejunal anastomotic leakage,with high technical success and fistula closure rates.It can effectively control infection and promote fistula healing,making it an important therapeutic option for this complication.关键词
胃切除术/手术后并发症/吻合口瘘/腔内负压辅助闭合技术Key words
Gastrectomy/Postoperative Complications/Anastomotic Leak/Endoluminal Vacuum-Assisted Closure分类
医药卫生引用本文复制引用
邵国益,王镇,浦凌宵,王苏睿,沈玥帆,耿良栋,薛徐夏,仲卫冬,赵振国,胡根,李家乐,华丽,刘金春,戴丽强..腔内负压辅助闭合技术治疗食管空肠吻合口漏的疗效与安全性:21例回顾性分析(附视频)[J].中国普通外科杂志,2026,35(4):721-728,8.基金项目
江苏省无锡市卫生健康委中青年拔尖人才基金资助项目(HB2023102) （HB2023102）
江苏省江阴市中青年卫生优秀人才基金资助项目(JYROYT202301) （JYROYT202301）
徐州医科大学附属医院发展基金资助项目(XYFZ202302) （XYFZ202302）
江苏省无锡市卫生健康委基金资助项目(M202551) （M202551）
江苏省无锡市卫生健康委科技成果和适宜技术推广基金资助项目(T202548). （T202548）
