EVT procedures
small defects
CAVITY
EVT procedures were performed with the patients under deep propofol sedation or general anesthesia. The sponge used was the EsoSponge (EsoSPONGE; Braun B. Melsungen, Germany), a polyurethane sponge of 50 mm in length and 13 mm in diameter.
During the initial endoscopy, the defect and extraluminal cavity were cleaned. The EVT technique was determined by the endoscopist, taking into consideration the defect and cavity width and the extent of the debris. Generally, patients with defects large enough for endoscope passage and big extraluminal cavities initially underwent extraluminal therapy, while patients with small defects and cavities proceeded straight to intraluminal therapy (

Schematic with accompanying endoscopic view of:
The appropriate sponge size was determined and, if necessary, it was trimmed based on the cavity width. Therapy was considered adequate if the cavity collapsed after application of the vacuum.Sponge placement was performed using the EsoSponge overtube or a grasping forceps, as preferred by the endoscopist. After sponge placement, the tube of the sponge was guided from the oral cavity to the nose and fixed with a plaster onto the nose. Correct positioning was confirmed under endoscopic vision and vacuum was applied. The pressure of the pump (ActiV.A.C.; 3 M Health Care, St. Paul, Minnesota, USA) was generally −50 mmHg (intracavitary sponge) to −75 mmHg (intraluminal sponge). Intraluminal sponges were exchanged once per week, and intracavitary sponges were exchanged twice per week.