Surgical endoscopic vacuum-assisted closure therapy (EVAC) in treating anastomotic leakages after major resective surgery of esophageal and gastric cancer

Background/Aim: Endoscopic vacuum-assisted closure therapy (EVAC) is a promisingnew technique for repairing upper gastrointestinal defects of different etiologies. As of 2018, however, no standardized recommendation exists. This articlereviewed EVAC in treating anastomotic leakagefollowing major resective surgery of esophageal (EC) and gastric cancer(GC).Materials and Methods: Only English-language literature was investigated. Only studies or data on EC and GC were included. Seven popular search engines (PubMed, Web of Science, ScienceDirect, Scopus, Google Scholar, ResearchGate, PubFacts) wereutilized. Results: A total of29 studies (17 retrospective, six prospective and six case reports) with a total of 209 patients. Range of anastomotic leakage closure was 66.7-100%. Anastomotic stricture was the most frequent long-term related complication (18 cases).Conclusion: EVAC appears to be an extremely useful treatment for postsurgical anastomotic leakage in patients with EC/GC. Almost all kinds of anastomotic leakage (silent to symptomatic, small to large) seem to be amenable to this technique.