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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2025; 17(12): 113305
Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.113305
Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.113305
Endoscopic vacuum-assisted closure as a first-line treatment for post-esophagectomy anastomotic leaks: A paradigm shift in management
Ioannis Katsaros, Markos Despotidis, Dimitrios Schizas, First Department of Surgery, National and Kapodistrian University of Athens, Athens 11527, Attikí, Greece
Stavros P Papadakos, Andreas Koutsoumpas, First Department of Gastroenterology, National and Kapodistrian University of Athens, Athens 11527, Attikí, Greece
Co-corresponding authors: Ioannis Katsaros and Dimitrios Schizas.
Author contributions: Katsaros I, Papadakos SP, and Despotidis M performed most of the writing; Koutsoumpas A and Schizas D critically reviewed the manuscript and were the supervisors of the project. All the author approval the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Ioannis Katsaros, First Department of Surgery, National and Kapodistrian University of Athens, Agiou Thoma 17, Athens 11527, Attikí, Greece.
Received: August 21, 2025
Revised: September 7, 2025
Accepted: October 27, 2025
Published online: December 27, 2025
Processing time: 126 Days and 5 Hours
Revised: September 7, 2025
Accepted: October 27, 2025
Published online: December 27, 2025
Processing time: 126 Days and 5 Hours
Core Tip
Core Tip: Post-esophagectomy anastomotic leak is a severe complication with increased morbidity and high risk of mortality. Endoscopic vacuum-assisted closure has emerged as an effective first-line treatment for managing this condition. The therapy applies continuous negative pressure to promote granulation tissue and accelerate healing. When compared to stenting, endoscopic vacuum-assisted closure has superior adaptability, enhanced drainage, and lower reintervention rates. Clinical studies confirm higher success rates and shorter hospital stays. However, the procedure requires experienced, multidisciplinary teams, and protocols need further standardization to optimize outcomes.