食管切除术虽然是食管癌的关键治疗方法，但并非没有不良事件。其中，吻合口瘘（AL）是最令人担心的并发症，威胁患者的生命并带来巨大的医疗费用。 AL管理复杂且缺乏标准化。鉴于与重做手术相关的高发病率和死亡率，这给本已脆弱的患者带来了风险，随着时间的推移，已经开发出了各种内窥镜治疗方法。自膨胀金属支架 (SEMS) 是 2000 年代初期使用最广泛的治疗方法。 SEMS 的作用机制包括覆盖壁缺损、保护其免受分泌物影响和促进愈合。 2010 年，内镜真空治疗 (EVT) 作为治疗 AL 的可行替代方案出现，并迅速获得临床实践的认可。 EVT 包括在缺损壁内部或邻近的负压下放置专用海绵，旨在清除渗漏并促进肉芽组织形成。最近，VAC 支架进入了食管切除术后 AL 的内镜治疗领域。该装置将完全覆盖的 SEMS 与集成的 EVT 海绵相结合，将 SEMS 排除缺陷和保持食管腔通畅的能力与 EVT 吸出分泌物和促进肉芽组织形成的能力相结合。尽管关于这种新装置的文献并不广泛，但 VAC-Stent 应用的早期结果已经显示出有希望的结果。本次审查旨在综合该设备的初步功效和安全性数据，深入分析其相对于传统技术的优势和劣势，探索需要改进的领域，并提出未来的方向。

Esophagectomy, while a pivotal treatment for esophageal cancer, is not without adverse events. Among these, anastomotic leak (AL) is the most feared complication, threatening patient lives and incurring significant healthcare costs. The management of AL is complex and lacks standardization. Given the high morbidity and mortality rates associated with redo-surgery, which poses risks for already fragile patients, various endoscopic treatments have been developed over time. Self-expandable metallic stents (SEMSs) were the most widely used treatment until the early 2000s. The mechanism of action of SEMSs includes covering the wall defect, protecting it from secretions, and promoting healing. In 2010, endoscopic vacuum therapy (EVT) emerged as a viable alternative for treating ALs, quickly gaining acceptance in clinical practice. EVT involves placing a dedicated sponge under negative pressure inside or adjacent to the wall defect, aiming to clear the leak and promote granulation tissue formation. More recently, the VAC-Stent entered the scenario of endoscopic treatment of post-esophagectomy ALs. This device combines a fully covered SEMS with an integrated EVT sponge, blending the ability of SEMSs to exclude defects and maintain the patency of the esophageal lumen with the capacity of EVT to aspirate secretions and promote the formation of granulation tissue. Although the literature on this new device is not extensive, early results from the application of VAC-Stent have shown promising outcomes. This review aims to synthesize the preliminary efficacy and safety data on the device, thoroughly analyze its advantages over traditional techniques and disadvantages, explore areas for improvement, and propose future directions.