Use of Endoscopic negative pressure therapy (ENPT) in Otorhinolaryngology – first experiences

Introduction:

Cervical esophageal perforations and pharyngeal defects belong to postoperative complications requiring treatment. Often the treatment is complex and the hospital length of stay is prolonged.

Endoscopic negative pressure therapy (ENPT) is a novel method for the treatment of transmural defects of the upper and lower gastrointestinal tract.

We report on our experience with ENPT in ENT-specific problems based on a case series of 10 patients.

Methods:

In ENPT, polyurethane sponges (PUS) attached to the tip of a drainage are placed transorally in the esophageal or pharyngeal wound area by endoscopy. A distinction is made between an intracavitary ENPT, in which the PUS is inserted through the defect into an extra-luminal wound cavity, and an intraluminal ENPT, in which the PUS is placed intra-luminal. After transnasal placement of the drainage tube, a continuous negative pressure is applied via an electronic suction pump. This causes the wound defect to close with simultaneous inner drainage. The sponge system is changed periodically (every 3 – 4 days) and the wound healing is monitored endoscopically.

Results:

A total of 10 patients were treated. Indications included high esophageal perforations (n = 5) and postoperative pharyngocutaneous, -tracheal and orocutaneous fistulas (n = 5). In all cases the defect healed completely. The median duration of treatment was 15 days (range 4 – 42).

Conclusions:

The ENPT can also be successfully used in Otorhinolaryngology for defect closure in high esophageal and pharyngeal defects. The results of this first retrospective case series should be verified by further studies.

Jonathan Loeck

Kath. Marienkrankenhaus gGmbH,

Alfredstraße 9, 22087

Hamburg

Email: [e-mail]

Publication History

Publication Date:
23 April 2019 (online)