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Endoscopy
DOI: 10.1055/a-2544-6448
Innovations and brief communications

Endoscopic vacuum therapy for the management of nonvariceal upper gastrointestinal bleeding: a valuable resource for the endoscopist’s toolbox

Paulo Ferreira Mega 
1   Gastrointestinal Endoscopy Unit, Department of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil (Ringgold ID: RIN117265)
,
Eduardo Guimarães Hourneaux de Moura 
2   Gastrointestinal Endoscopy Unit, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil (Ringgold ID: RIN117265)
3   Gastrointestinal Endoscopy Division, Instituto D'Or de Pesquisa e Ensino, Hospital Vila Nova Star, Sao Paulo, Brazil (Ringgold ID: RIN614890)
,
Alexandre Moraes Bestetti 
2   Gastrointestinal Endoscopy Unit, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil (Ringgold ID: RIN117265)
3   Gastrointestinal Endoscopy Division, Instituto D'Or de Pesquisa e Ensino, Hospital Vila Nova Star, Sao Paulo, Brazil (Ringgold ID: RIN614890)
,
Daryl Ramai
4   Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, United States (Ringgold ID: RIN1861)
,
Atul Kumar
5   Piedmont Physicians Gastroenterology, Piedmont Healthcare Inc, Atlanta, United States (Ringgold ID: RIN165118)
,
Ludhmila Abrahão Hajjar
3   Gastrointestinal Endoscopy Division, Instituto D'Or de Pesquisa e Ensino, Hospital Vila Nova Star, Sao Paulo, Brazil (Ringgold ID: RIN614890)
6   Department of Clinical Emergencies and Intensive Care, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil (Ringgold ID: RIN117265)
,
Christopher C. Thompson 
4   Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, United States (Ringgold ID: RIN1861)
,
Diogo Turiani Hourneaux de Moura 
2   Gastrointestinal Endoscopy Unit, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil (Ringgold ID: RIN117265)
3   Gastrointestinal Endoscopy Division, Instituto D'Or de Pesquisa e Ensino, Hospital Vila Nova Star, Sao Paulo, Brazil (Ringgold ID: RIN614890)
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The expanding role of endoscopic vacuum therapyEndoscopy eFirst
DOI: 10.1055/a-2604-8278

Abstract

Background

Endoscopic vacuum therapy (EVT) is a well-established method for managing gastrointestinal perforations. During the COVID pandemic, case reports demonstrated the effective use of EVT in controlling COVID-related diffuse duodenal bleeding. Owing to its unique mechanism of action, this approach may also be effective for other types of nonvariceal upper gastrointestinal bleeding (NVUGIB). This study aimed to assess EVT in the treatment of NVUGIB.

Methods

This retrospective analysis of a prospectively collected database included patients who underwent EVT for the treatment of NVUGIB. The primary outcome was clinical success. Secondary outcomes included technical success and safety. Subgroup analysis comparing the outcomes for patients with and without COVID was conducted.

Results

19 patients underwent EVT for NVUGIB, with 57.9% having failed other therapies. Technical success occurred in all patients, and clinical success was achieved in 89.5%. There was no difference in the clinical success rates between patients with or without COVID (88% versus 91%, respectively). No procedure-related adverse events occurred.

Conclusion

EVT appears to be safe and effective in the management of NVUGIB. This approach could be particularly useful in refractory or diffuse bleeding. Larger studies are warranted to validate these findings.

Supplementary Material



Publication History

Received: 26 August 2024

Accepted after revision: 21 February 2025

Accepted Manuscript online:
21 February 2025

Article published online:
16 May 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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