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. 2020 Apr;13(2):141-146.
doi: 10.1111/ases.12733. Epub 2019 Jul 12.

Endoscopic repair of anastomotic leakage after low anterior resection for rectal cancer: A systematic review

Angeliki Chorti  1 , George Stavrou  1 , Veronica Stelmach  1 , Georgia Tsaousi  1 , Antonios Michalopoulos  1 , Theodosios S Papavramidis  1 , Katerina Kotzampassi  1
Affiliations

Endoscopic repair of anastomotic leakage after low anterior resection for rectal cancer: A systematic review

Angeliki Chorti et al. Asian J Endosc Surg. 2020 Apr.

Abstract

Introduction: Anastomotic leakage (AL) after low anterior resection for rectal cancer is a severe complication. Except for re-operation, several endoscopic options have been proposed for the minimal invasive treatment of AL, including the endoluminal vacuum devices, tissue sealants and Over-The-Scope-Clip (OTSC) technique. The aim of the present review is to evaluate the effect of alternative treatment options for AL repair, by means of endoscopy.

Method: A bibliographic search was performed in the international literature. Ten case reports and series were finally included, reporting 75 cases of endoscopic repair of AL. A descriptive statistical analysis and a systematic review were performed.

Results: The patients' mean age was 65.84 ± 9.92 years (95% CI: 61.70-68.76), the male-to-female ratio being 1.5:1. The mean diameter of the cavity was 5.17 ± 3.32 cm (95% CI: 4.03-6.31). The mean time until the diagnosis was 44.15 ± 105.91 days (95% CI: 13.39-74.90). Vacuum-assisted closure therapy was the most common technique (52%), followed by fibrin glue (25.3%) and OTSC (22.7%). As supplementary therapy, OTSC was applied in 8.3%, vacuum-assisted closure in 25%, endoclips in 4.2%, while fibrin glue was the most frequently used (62.5%).

Conclusion: Endoscopic management of AL after low anterior resection is considered as an alternative to surgical treatment with promising results.

Keywords: OTSC; VAC; anastomotic leakage; endoscopic treatment; fibrin glue; low anterior resection.

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References

REFERENCES

    1. Jimenez-Rodriguez RM, Araujo-Miguez A, Sobrino-Rodriguez S, et al. A new perspective on vacuum-assisted closure for the treatment of anastomotic leak following low anterior resection for rectal cancer, is it worthy? Surg Innov. 2018;25(4):350-356.
    1. Chopra SS, Mrak K, Hünerbein M. The effect of endoscopic treatment on healing of anastomotic leaks after anterior resection of rectal cancer. Surgery. 2009;145(2):182-188.
    1. Cong ZJ, Hu LH, Bian ZQ, et al. Systematic review of anastomotic leakage rate according to an international grading system following anterior resection for rectal cancer. PLoS One. 2013;8(9):e75519.
    1. Blumetti J, Abcarian H. Management of low colorectal anastomotic leak: preserving the anastomosis. World J Gastrointest Surg. 2015;7(12):378-383.
    1. Lippert E, Klebl FH, Schweller F, et al. Fibrin glue in the endoscopic treatment of fistulae and anastomotic leakages of the gastrointestinal tract. Int J Colorectal Dis. 2011;26(3):303-311.

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