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. 2017;30(6):649-653.
doi: 10.20524/aog.2017.0194. Epub 2017 Sep 23.

Long-term efficacy of vacuum-assisted therapy (Endo-SPONGE®) in large anastomotic leakages following anterior rectal resection

Alessandro Mussetto  1 , Rosario Arena  1 , Andrea Buzzi  1 , Lorenzo Fuccio  2 , Silvia Dari  1 , Mario Luciano Brancaccio  1 , Omero Triossi  1
Affiliations

Long-term efficacy of vacuum-assisted therapy (Endo-SPONGE®) in large anastomotic leakages following anterior rectal resection

Alessandro Mussetto et al. Ann Gastroenterol. 2017.

Abstract

Background: The aim of our study was to test the long-term efficacy of Endo-SPONGE® therapy in a group of patients treated in our center with vacuum-assisted therapy because of anastomotic leakages after colorectal surgery.

Methods: Eleven patients [male: 6; mean age: 71 (range: 44-82) years] who had anastomotic leakage treated with Endo-SPONGE® placement were included in the study. Patient records were examined retrospectively. All patients with documented anastomotic leakage on abdominal computed tomography following an anterior resection of the rectum for rectal cancer underwent sigmoidoscopy to determine the extent of the anastomotic defect and the size of the presacral abscess.

Results: Ten of the 11 patients (90.9%) showed closure of the anastomotic leakage after a mean of 16 sponge changes. During follow up [mean: 29 (range: 6-64) months], we observed two cases of anastomotic stricture. Treatment failure was observed in one patient who presented an increased size of dehiscence after 23 sessions of endoscopic treatment, despite an initial good response.

Conclusions: Our study substantially confirms previous conclusions and reaffirms that Endo-SPONGE® treatment for colorectal anastomotic leakages, performed in suitable patients, represents a successful and safe approach. The reduction in wound closure time, mild-to-moderate discomfort and possibly shorter hospitalization suggest that Endo-SPONGE® treatment can be a prominent therapeutic regimen with adequate patient acceptance.

Keywords: Endo-SPONGE®; anastomotic leakage; colorectal surgery; rectal cancer; therapy.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
Two Endo-SPONGEs® were inserted because of the large size of the leakage
Figure 2
Figure 2
Example of Endo-SPONGE®-supported closure of the anastomotic leakage
Figure 3
Figure 3
Barium enema before Endo-SPONGE® treatment and one month after
See this image and copyright information in PMC

References

    1. Pakkastie TE, Luukkonen PE, Järvinen HJ. Anastomotic leakage after anterior resection of the rectum. Eur J Surg. 1994;160:293–297. discussion 299-300. - PubMed
    1. Jech B, Felberbauer FX, Herbst F. Complications of elective surgery for rectal cancer. Eur Surg. 2007;39:8–14.
    1. Ptok H, Marusch F, Meyer F, Schubert D, Gastinger I, Lippert H, Study Group Colon/Rectum Carcinoma (Primary Tumour) Impact of anastomotic leakage on oncological outcome after rectal cancer resection. Br J Surg. 2007;94:1548–1554. - PubMed
    1. Jung SH, Yu CS, Choi PW, et al. Risk factors and oncologic impact of anastomotic leakage after rectal cancer surgery. Dis Colon Rectum. 2008;51:902–908. - PubMed
    1. Lee WS, Yun SH, Roh YN, et al. Risk factors and clinical outcome for anastomotic leakage after total mesorectal excision for rectal cancer. World J Surg. 2008;32:1124–1129. - PubMed

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