Acute esophageal perforations are traditionally managedsurgically, although minimally invasive approaches,including esophageal clipping, stent placement, suturing,and endoluminal vacuum therapy (EndoVAC), have beenreported. 1-3 The EndoVAC approach, which relies on amodification of the wound-VAC technique, has beenused to treat esophageal perforations and leaks withsuccess. 4-9 These cases, often reported in the surgicalliterature, have demonstrated healing of the perforationor leak while avoiding the morbidity and mortality associ-ated with surgery. 4 Although clips, stent placement, andsuturing are often considered as initial options fortreating esophageal perforations, their role can belimited, with large perforations not amenable to clippingor not adequately covered with stent placement(secretions, debris, and food may leak “around” the stentinto the perforation); additionally, suturing is dependenton local expertise.
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