Kashintsev AA, Eselevich RV, Surov DA, Balyura OV, Proutski V. Isolation techniques for gastrointestinal tract defects: Two case reports. World J Gastrointest Endosc 2025; 17(8): 109104 [DOI: 10.4253/wjge.v17.i8.109104]
Corresponding Author of This Article
Aleksei A Kashintsev, MD, PhD, PANDICA LTD, 22 Great James Street, London WC1N 3ES, United Kingdom. alexey.kashintsev@pandica.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Aug 16, 2025; 17(8): 109104 Published online Aug 16, 2025. doi: 10.4253/wjge.v17.i8.109104
Isolation techniques for gastrointestinal tract defects: Two case reports
Aleksei A Kashintsev, Roman Vladimirovich Eselevich, Dmitry Aleksandrovich Surov, Oleg Valeryevich Balyura, Vitali Proutski
Aleksei A Kashintsev, Vitali Proutski, PANDICA LTD, London WC1N 3ES, United Kingdom
Roman Vladimirovich Eselevich, Dmitry Aleksandrovich Surov, Oleg Valeryevich Balyura, Naval Surgery, Military Medical Academy, Saint Petersburg 197758, Saint-Peterburg, Russia
Co-first authors: Aleksei A Kashintsev and Roman Vladimirovich Eselevich.
Co-corresponding authors: Aleksei A Kashintsev and Vitali Proutski.
Author contributions: Kashintsev AA and Surov DA contributed to conceptualization; Eselevich RV and Balyura OV contributed to investigation; Kashintsev AA and Proutski V contributed to methodology and device design; Kashintsev AA and Proutski V contributed to writing – original draft; All authors contributed to review & editing; Kashintsev AA contributed to supervision.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aleksei A Kashintsev, MD, PhD, PANDICA LTD, 22 Great James Street, London WC1N 3ES, United Kingdom. alexey.kashintsev@pandica.com
Received: April 29, 2025 Revised: June 3, 2025 Accepted: June 27, 2025 Published online: August 16, 2025 Processing time: 108 Days and 5.8 Hours
Abstract
BACKGROUND
Gastrointestinal (GI) tract injuries and defects form a heterogeneous group of conditions often presenting with fistula formation. Management depends on factors such as defect number, anatomical location, and patient status, requiring a therapy that addresses multiple etiopathogenic factors.
CASE SUMMARY
We present two cases of patients who underwent total gastrectomy for gastric malignancy. A combined therapeutic approach was employed, based on isolating the injury site with local vacuum-assisted closure (VAC) therapy and simultaneous enteral nutrition. This method facilitated successful healing and enabled the identification of previously undetected defects not recognized by conventional diagnostics.
CONCLUSION
The combination of injury site isolation, local VAC therapy, and enteral feeding proved to be safe, effective, and easily adaptable to standard surgical practice. This approach may expand surgical options in the treatment of GI tract injuries and defects.
Core Tip: The treatment of gastrointestinal tract defects and fistulas remains a complex challenge without a standardized approach, due to the highly variable and often unique nature of injuries. Our experience highlights a novel method combining isolation of the affected gastrointestinal segment with local vacuum-assisted therapy while maintaining enteral nutrition. This approach not only facilitates early detection and dynamic monitoring of fistulas but also promotes faster healing by preventing contact with gastrointestinal contents and preserving mucosal integrity through continued enteral feeding. By applying this method in oncologic patients undergoing similar surgeries, we demonstrate its feasibility, safety, and potential to significantly improve clinical outcomes. Further exploration of segmental isolation may expand therapeutic options for various abdominal pathologies.
