Endoscopic Vacuum Therapy (EVT) for the Treatment of Post-Bariatric Surgery Leaks and Fistulas: a Systematic Review and Meta-analysis

Obes Surg. 2022 Oct;32(10):3435-3451. doi: 10.1007/s11695-022-06228-0. Epub 2022 Aug 3.

Abstract

Bariatric surgery remains the most effective treatment for morbid obesity and its comorbidities. However, post-surgical leaks and fistulas can occur in about 1-5% of patients, with challenging treatment approaches. Endoscopic vacuum therapy (EVT) has emerged as a promising tool due to its satisfactory results and accessibility. In this first systematic review and meta-analysis on the subject, EVT revealed rates of 87.2% clinical success, 6% moderate adverse events, and 12.5% system dislodgements, requiring 6.47 EVT system exchanges every 4.39 days, with a dwell time of 25.67 days and a total length of hospitalization of 44.43 days. Although our results show that EVT is a safe and effective therapy for post-surgical leaks and fistulas, they should be interpreted with caution due to the paucity of available data.

Keywords: Endoscopic vacuum therapy; Obesity; Endoscopy; Leaks; Fistulas; Bariatric surgery.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Anastomotic Leak / etiology
  • Anastomotic Leak / surgery
  • Bariatric Surgery* / adverse effects
  • Endoscopy / methods
  • Fistula* / etiology
  • Humans
  • Negative-Pressure Wound Therapy* / methods
  • Obesity, Morbid* / surgery
  • Retrospective Studies
  • Treatment Outcome