Long-term efficacy of endoscopic vacuum therapy for the treatment of colorectal anastomotic leaks

Abstract Background Anastomotic leaks are a severe complication after colorectal surgery. We aimed to evaluate the long-term efficacy of endoscopic vacuum therapy for their treatment. Methods Retrospective review of a series of post-surgical colorectal leaks treated with endoscopic vacuum therapy, w...

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Bibliographic Details
Published in:Digestive and liver disease 2015-04, Vol.47 (4), p.342-345
Main Authors: Arezzo, Alberto, Verra, Mauro, Passera, Roberto, Bullano, Alberto, Rapetti, Lisa, Morino, Mario
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anastomosis, Surgical - adverse effects
Anastomotic leak
Anastomotic Leak - therapy
Colon - surgery
Colonoscopy - methods
Colorectal surgery
Colorectal Surgery - adverse effects
Endoscopic vacuum
Female
Follow-Up Studies
Gastroenterology and Hepatology
Humans
Male
Middle Aged
Postoperative complications
Rectum - surgery
Retrospective Studies
Time Factors
Treatment Outcome
Vacuum
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Summary:Abstract Background Anastomotic leaks are a severe complication after colorectal surgery. We aimed to evaluate the long-term efficacy of endoscopic vacuum therapy for their treatment. Methods Retrospective review of a series of post-surgical colorectal leaks treated with endoscopic vacuum therapy, with minimum follow-up of 1 year. Generalized peritonitis or haemodynamic instability was considered contraindication to endoscopic treatment. Results Endoscopic vacuum therapy was applied in 14 patients with colorectal leak, in 2 cases complicated by recto-vaginal fistula. Overall success rate was 79%, favoured by early beginning of treatment (90%) and presence of a stoma (100%) and no preoperative radiotherapy (86%). Median duration of treatment was 12.5 sessions (range 4–40). Median time for complete healing was 40.5 days (range 8–114), for a median cost of treatment of 3125 Euros. No complication related to endoscopic vacuum therapy was observed. Further surgery was required in 3 cases. Conclusion Endoscopic vacuum therapy is a safe treatment for post-surgical leaks, with high success rates.
ISSN:1590-8658
1878-3562
DOI:10.1016/j.dld.2014.12.003