Distal esophageal adenocarcinoma
- 66-year-old male
- Ivor Lewis esophagectomy with intrathoracic esophago-gastric anastomosis
- Anastomotic leakage treated with VAC-Stent
10days post-surgery
- Thoracic pain and respiratory insufficiency
- Lab: Leukocytes 19,6; CRP 384
- CT-scan and endoscopy
![](https://evt-academy.com/wp-content/uploads/2023/04/Schermafbeelding-2023-10-04-om-17.18.18-e1696436166340-500x335.png)
![](https://evt-academy.com/wp-content/uploads/2023/04/Schermafbeelding-2023-10-04-om-17.18.46-500x351.png)
Anastomotic leakage proximal from gastric conduit, expanding into mediastinum and right pleural cavity
![](https://evt-academy.com/wp-content/uploads/2023/04/Schermafbeelding-2023-10-04-om-17.35.50-e1696433824734-500x391.png)
![](https://evt-academy.com/wp-content/uploads/2023/04/Schermafbeelding-2023-10-04-om-17.34.49-e1696433869283-500x391.png)
Anastomotic defect with access to the mediastinum.
Treatment with VAC-Stent was initiated
- Treatment duration: 12 days
- VAC-Stent cycles: 2
- Vacuum settings: -125mmHg on day of placement and -75mmHg from the next day on
- During treatment, the patient had a full liquid diet
In hind sight, the defect had already closed after the first VAC-Stent. As this was an early case during the VAC-Stent implementation phase, it was decided to stay on the safe side and place another VAC-Stent.
![](https://evt-academy.com/wp-content/uploads/2023/04/Schermafbeelding-2023-10-04-om-18.19.51-e1696436464423-500x394.png)
![](https://evt-academy.com/wp-content/uploads/2023/04/Schermafbeelding-2023-10-04-om-18.20.26-e1696436489160-500x395.png)
Endoscopic images after respectively 6 and 12 days of VAC-Stent treatment.