Single-component endoscopic vacuum therapy technique in the treatment of transmural defects of the upper gastrointestinal tract: results of a retrospective study

Background. Transmural defects of the upper gastrointestinal (GI) tract remain a challenging clinical condition associated with high morbidity and mortality. Minimally invasive techniques, particularly endoscopic vacuum therapy (EVT), have emerged as a promising treatment option. Objective. To evaluate the efficacy and safety of EVT applied as monotherapy in patients with transmural defects of the upper GI tract. Materials and methods. A retrospective study included 65 patients treated with EVT at a single tertiary center (2021–2023). Negative pressure was individually adjusted (−70 to −120 mmHg), with sponge replacement every 3–5 days. Outcomes were evaluated by defect closure rate, number of sessions, hospital stay, and complications. Results. Defect closure was achieved in 86,2 % of cases. Acute perforations required fewer sessions, while anastomotic leakage and chronic fistulas demanded prolonged treatment. Adverse events were rare and manageable; mortality (12,3 %) was mainly due to comorbidities. Conclusion. EVT used in monotherapy is an effective and safe modality for the management of transmural defects of the upper GI tract and may serve as a first-line treatment option in patients not eligible for surgical intervention.