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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

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