Endoluminal vacuum therapy for anastomotic leaks after rectal surgery

Abstract

Anastomotic leakage after rectal surgery is a very serious complication and is the main cause of postoperative morbidity and mortality. We describe three cases of rectal leakage which we treated with endoscopic vacuum-assisted closure. We used the Endo-SPONGE (B. Braun Aesculap AG, Germany), which consists of an open-cell, cylindrical polyurethane sponge connected to a drainage tube which is linked to a vacuum system to exert constant suction. The possible role of this new tool in the management of anastomotic leaks is also discussed.

Use of the endostapler for the treatment of non-healing sinus secondary to a dehisced colorectal anastomosis

“…A sponge connected to vacuum suction is introduced into the cavity of the sinus and changed twice weekly. The technique was less successful in patients who received radiation [3]. Probably such a technique is a viable option for a branching sinus.…”

Enterovesical fistulas: diagnosis and management

“…The endoscopic management of bowel perforations\1 cm has been definitively accepted in the clinical setting [57] and has recently been employed in the management of spontaneous or iatrogenic leaks [58]. Concerning EVF, data in the recent literature involve some endoscopic reports.…”

Endoscopic fixation of the rectum for rectal prolapse: a feasibility and survival experimental study

“…Different groups have reported on a wide range of applications of endoluminal, hybrid (laparoscopic and endoscopic) procedures as well as NOTES animal and human clinical studies [25,26,28,[30][31][32]. The endoluminal therapeutic procedures that have been widely reported thus far include colonoscopic stenting for obstructive lesions, polypectomy including full-thickness excisions, and creation of an anastomosis [9,33].…”

“…Endoluminal surgery is another POD postoperative day manifestation of this progress, an arena we believe to be particularly vital for improving outcomes in intestinal surgery [25][26][27][28]. Localized benign conditions are particularly well suited for innovative changes in therapies, as long-term outcomes are not as crucial as for malignancies.…”