ASGE DDW Videos from Around the World | 2023-MANAGEMENT OF A HUGE INFECTED ESOPHAGEAL DEFECT POST SUBMUCOSAL TUNNELLING ENDOSCOPIC RESECTION (STER) USING ENDOSCOPIC VACUUM THERAPY EVT

MANAGEMENT OF A HUGE INFECTED ESOPHAGEAL DEFECT POST SUBMUCOSAL TUNNELLING ENDOSCOPIC RESECTION (STER) USING ENDOSCOPIC VACUUM THERAPY EVT

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Video Transcription

Video Summary

The video content summarizes the management of a large infected esophageal defect through submucosal tunnel endoscopic resection. A 32-year-old patient presented with dysphagia and weight loss, and an assessment revealed a large submucosal tumor. Initially planning for endoscopic submucosal dissection (ESD), the strategy was changed to submucosal tunneling to isolate the lesion originating from the fourth layer. During the procedure, a large mucosal incision was closed using hemoclips, and the lesion was extracted in pieces. However, the patient developed a mediastinal leak with signs of infection. To address this, a handmade modified endovacuum was placed to treat the defect, leading to marked improvement. After multiple endovacuum exchanges, the defect decreased in size without infection signs. The final gastroscope examination showed a sealed defect, suggesting the success of the modified endovacuum therapy.

Asset Subtitle

Honorable Mention

Keywords

esophageal defect management

submucosal tunnel endoscopic resection

dysphagia

endoscopic submucosal dissection

mediastinal leak