Procedure
small defects, upper esophageal sphincter
CAVITY
EVT procedures were performed under deep propofol sedation or general anesthesia. The sponge used was either an Eso-SPONGE (B. Braun Melsungen AG, Melsungen, Germany), or a self-fabricated sponge using a suction tube and absorbent wound dressing (Suprasorb CNP Drainage Film; Lohmann & Rauscher International, Rengsdorf, Germany).The defect and any extraluminal cavity were cleaned during initial endoscopy. The EVT technique used was determined by the endoscopist after consideration of the defect and cavity widths and the extent of debris. Generally, patients with defects large enough for endoscope passage with large extraluminal cavities received intracavitary therapy and patients with small defects received intraluminal therapy. In some cases, intracavitary and intraluminal therapies were combined.Under endoscopic visualization, the sponge was adequately positioned, and vacuum was applied at a negative pressure of –50 mmHg to –125 mmHg depending on the local standard operating procedure.The frequency of sponge exchanges varied from 1 day to 1 week, depending on the center. In general, intracavitary sponges were exchanged more often than intraluminal sponges.Cervical defects were not considered a contraindication to EVT as long as there was sufficient room to place a sponge to cover the defect without extending through the upper esophageal sphincter.