Efficacy of endoscopic vacuum therapy in esophageal luminal defects: a systematic review and meta-analysis
- Author:
Ishaan VOHRA
1
;
Harishankar GOPAKUMAR
;
Neil R. SHARMA
;
Srinivas R. PULI
Author Information
- Publication Type:Systematic Review and Meta-analysis
- From:Clinical Endoscopy 2025;58(1):53-62
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:Endoscopic vacuum-assisted closure (EVAC) is a novel technique used to repair esophageal perforation and leaks. Varying data have been reported on the overall success rate of EVAC. We aimed to conduct a meta-analysis of the available data on the clinical success rate of EVAC.
Methods:Electronic databases were searched for publications addressing the efficacy of EVAC in esophageal luminal defects. Pooling was conducted using both fixed and random-effects models. The overall clinical success of EVAC therapy was considered the primary outcome, whereas, overall complication rates, need for adjunct therapy, and mortality were considered secondary outcomes.
Results:In total, 366 patients were included in the study. On pooled analysis, the mean age was 66 years with 68.32% of patients being men. Overall pooled clinical success rate of EVAC therapy was 87.95%. Upon subgroup analysis, the pooled clinical success rate of postsurgical anastomotic leak and transmural esophageal perforation were found to be 86.57% and 88.89%, respectively. The all-cause hospital mortality was 14% and 4.2% in patients with esophageal perforation and EVAC, respectively.
Conclusions:This study demonstrates that EVAC therapy has a high overall clinical success rate, with low mortality. EVAC therapy seems to be a promising procedure with excellent outcomes in patients with luminal esophageal defects.
