VacStent as an Innovative Approach in the Treatment of Anastomotic Insufficiencies and Leakages in the Gastrointestinal Tract-Review and Outlook

• Published in: Life (Basel, Switzerland) Switzerland), 2024-06, Vol.14 (7), p.821
• Main Authors: Yohannes, Alexander, Knievel, Judith, Lange, Jonas, Dormann, Arno J, Hügle, Ulrich, Eisenberger, Claus F, Heiss, Markus M
• Format: Article
• Language: English
• Subjects: anastomotic insufficiency; Catheters; Comparative analysis; covered stent; Effectiveness; endoscopic vacuum therapy; Endoscopy; Enteral nutrition; Esophagus; esosponge; Feasibility studies; gastrointestinal leakage; Gastrointestinal system; Gastrointestinal tract; Iatrogenesis; Implants; Medical devices; Medical equipment; Medical technology; Mortality; Patients; Risk analysis; Sepsis; Stents; Surgery; Surgical anastomosis; VacStent; Wound healing
• ISSN: 2075-1729; 2075-1729
• DOI: 10.3390/life14070821

Anastomotic insufficiencies are severe complications of abdominal surgery, often leading to prolonged hospitalization, serious tissue inflammation, and even sepsis, along with the need for recurrent surgery. Current non-surgical treatments such as self-expanding metal stents (SEMSs) and endoscopic vacuum therapy (EVT) have limitations, including stent migration or perforation. This review evaluates the effectiveness of the VacStent GI (Möller Medical GmbH, Fulda, Germany), a novel medical device combining SEMS and negative-pressure wound therapy in treating gastrointestinal leaks. Data were gathered from four prospective studies and compared with existing treatments. Studies on the VacStent GI application demonstrate technical success and competitive closure rates in upper gastrointestinal leaks, with minimal complications reported. Comparative analyses with SEMS and EVT reveal promising and most importantly equally good outcomes while maintaining the possibility for sustained enteral nutrition and reducing the risk of stent migration. The VacStent GI presents a promising alternative to current non-surgical treatments. Ongoing research aims to validate its efficacy in lower gastrointestinal leaks and comprehensively establish its role in leak management. Further investigation is necessary to confirm these findings and optimize treatment protocols. Future usages of the VacStent GI in colonic anastomotic insufficiencies promise an effective approach and might be able to lower the rates of necessary implementations of a stoma.