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case_images: Patient One: (a) Before VACStent insertion, showing the oesophageal defect. (b) After VACStent treatment, demonstrating successful defect closure.
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case_images: The patient was treated with antibiotics and VACStent insertions, requiring two stent placements (Fig. 1a). By the second stent removal, the anastomotic leak had closed (Fig. 1b).
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case_images: Patient Two: (a) Before VACStent insertion, showing the oesophageal defect. (b) After VACStent treatment, demonstrating successful defect closure.
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case_images: Initial diagnostic tests, including a gastrografin swallow, identified a defect in the distal left lateral wall of the oesophagus, measuring  1 cm with an extraluminal component of at least 5 cm (Fig. 2a). A CT thorax on day 16 post-diagnosis confirmed proper placement of the VACStent with no ongoing leak (Fig. 2b).
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case_images: Patient Three: Before VACStent insertion, showing the oesophageal defect.
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case_images: The endoscopy revealed a 2 cm linear defect in the lower oesophagus just above the gastroesophageal junction (Fig. 3), and the VACStent was connected to 125 mmHg of negative pressure, confirming appropriate positioning.
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case_images: Patient Four: (a) Before VACStent insertion, showing the oesophageal defect. (b) After VACStent treatment, demonstrating successful defect closure.
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case_images: A subsequent OGD on postoperative day 8 revealed a 20% staple line defect (Fig. 4a), leading to VACStent and right chest drain insertion. Following the removal of the VACStent on postoperative day 13 (Fig. 4b), the patient underwent a prolonged antibiotic course and received dietician support for jejunal feedings.