A new review of existing studies suggests that endoscopic vacuum-assisted closure (EVAC) and similar vacuum-based techniques may help close esophageal leaks and perforations in children. The analysis included 52 pediatric patients from small observational studies. In the most detailed group of 35 patients, 33 (94.3%) achieved successful closure. In the broader group of 52 patients, 48 (92.3%) had successful closure, with no variation between studies.
However, the procedure is not without risk. Among the 35 patients with detailed data, 16 experienced clinically relevant complications, with stricture being the most common. Additionally, 6 of those 35 patients required rescue surgery. The review did not report on serious adverse events or long-term outcomes.
The main limitation is that the evidence comes from small, observational studies, not randomized trials. This means the results show an association, not proof, that vacuum therapy works. The authors emphasize that standardized prospective data are needed before definitive recommendations can be made.
For parents and caregivers, this review offers hope that vacuum therapy is a promising option for carefully selected children with accessible leaks or perforations. However, it is not yet clear which children benefit most or how this compares to other treatments. Anyone considering this approach should discuss it thoroughly with their child's medical team.
