Endoscopic negative pressure therapy for leaks with large cavities in the upper gastrointestinal tract: is it a feasible therapeutic option?

Kouladouros, Konstantinos; Belle, Sebastian; Reißfelder, Christoph; Kähler, Georg

doi:10.1080/00365521.2020.1861645

Cited by 8 publications

(4 citation statements)

References 23 publications

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“…ENPT was developed to treat complex wounds and is nowadays increasingly used for the treatment of both upper and lower GI ALs. In contrast to CT, endoscopy is of advantage since it allows a simultaneous diagnosis, characterization, and, importantly, therapy of AL [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Management of colorectal anastomotic leakage using endoscopic negative pressure therapy with or without protective ostomy: a retrospective study

Șandra-Petrescu

Tzatzarakis

Kähler

et al. 2021

Int J Colorectal Dis

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Purpose Management of colorectal anastomotic leakage (AL) is patient-oriented and requires an interdisciplinary approach. We analyzed the management of AL according to its severity and presence of ostomy and proposed a therapy algorithm. Methods We identified all patients who underwent colorectal surgery and developed an AL in our clinic between 2012 and 2017. The management of AL was retrospectively analyzed according to the severity grade: asymptomatic (A), requesting interventional or antibiotic therapy (B), undergoing re-operation (C). The groups were compared according to the leakage characteristics, presence of ostomy, and patient clinical conditions. Results We identified 784 consecutive patients meeting the inclusion criteria. Of these, 10.8% experienced an AL (A = 18%, B = 48%, and C = 34%). The rate of successful ostomy closure was 100% (A), 68% (B), and 62% (C), respectively. Within group B, 91% of the patients were treated solely by endoscopic negative pressure therapy (ENPT), whereas 37% of the patients within group C required ENPT in addition to surgery. Seven cases within group B (17%) required no protective ostomy (nOB) during ENPT which was itself shorter and required less cycles in comparison to group B with ostomy (OB) (p = 0.017 and 0.111, respectively). Moreover, the leakage distance to anal verge was higher in the OB subgroup (p < 0.001). Conclusion ENPT for the treatment of colorectal AL is efficient in combination with operative revision or protective ostomy. In selected patients, it is feasible also in the absence of a protective ostomy.

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Section: Discussionmentioning

confidence: 99%

Management of colorectal anastomotic leakage using endoscopic negative pressure therapy with or without protective ostomy: a retrospective study

Șandra-Petrescu

Tzatzarakis

Kähler

et al. 2021

Int J Colorectal Dis

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“…Both in intracavitary and intraluminal EVT, the negative pressure applied to the sponge would cause the cavity or lumen to collapse around it and seal the system without the need for an airtight seal [1,4,11]. The sponge has to be changed regularly, usually 2-3 times per week, until the defect is completely closed or the remaining cavity is small, covered with healthy granular tissue, and has adequate drainage to the lumen [11][12][13][14][15]. EVT has shown very good results when used for the treatment of a wide range of defects in the entire gastrointestinal tract, with success rates sometimes exceeding those of surgical treatment and with considerably less morbidity and mortality, leading some authors to describe it as the "new gold standard" in the treatment of those patients [16].…”

Section: Basic Principles Of Evt and Limitations Of The Polyurethane ...mentioning

confidence: 99%

The Role of Open-Pore Film Drainage Systems in Endoscopic Vacuum Therapy: Current Status and Review of the Literature

Kouladouros,

Wichmann,

Loske

2023

Visc Med

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Background: Endoscopic vacuum therapy (EVT) is an increasingly popular endoscopic technique used for the treatment of wall defects in the gastrointestinal tract. Open-pore film drainage (OFD) systems are a new addition to the armamentarium of EVT and have shown encouraging results in a wide spectrum of applications. The aim of this review is to summarize the current literature on the applications of OFD systems in the gastrointestinal tract. Summary: Open-pore film drainage (OFD) systems have been used for the treatment of several defects of the gastrointestinal tract. The small size and easy placement of these devices make them very useful, particularly for the treatment of defects that are small in size or difficult to reach. OFDs have been successfully used for both perforations and anastomotic leaks in various locations, with most reports focusing on the treatment of duodenal defects, although successful applications in the esophagus, stomach, and colon have also been reported. Lately, the role of OFDs in preemptive EVT has also been explored. Key Messages: OFD systems are easy to use, particularly for small defects and challenging localizations. The current literature, consisting mainly of small case series and case reports, shows encouraging results, but further prospective studies are needed to explore and verify the indications and technical aspects of this innovative method.

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“…B. bei der Ausleitung von 5 nasalen Drainageschläuchenaber deutlich eingeschränkt. Daher bietet sich die Anwendung von Haupt-und Nebenschwämmen mit nur einem ausgeleiteten Drainageschlauch an [32,33] (▶ Abb. 9 u.…”

Section: Haupt-und Nebenschwämmeunclassified

Endoskopische Vakuumtherapie der Anastomoseninsuffizienz – Schritt für Schritt

Kantowski¹,

Karstens²

2021

Gastroenterologie up2date

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Endoscopic negative pressure therapy for leaks with large cavities in the upper gastrointestinal tract: is it a feasible therapeutic option?

Cited by 8 publications

References 23 publications

Management of colorectal anastomotic leakage using endoscopic negative pressure therapy with or without protective ostomy: a retrospective study

Management of colorectal anastomotic leakage using endoscopic negative pressure therapy with or without protective ostomy: a retrospective study

The Role of Open-Pore Film Drainage Systems in Endoscopic Vacuum Therapy: Current Status and Review of the Literature

Endoskopische Vakuumtherapie der Anastomoseninsuffizienz – Schritt für Schritt

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