Neue Strategien und Materialien bei der endoskopischen Vakuumtherapie im unteren Gastrointestinaltrakt

Kantowski, Marcus; Kunze, Andreas

doi:10.1007/s00104-018-0740-0

Cited by 10 publications

(8 citation statements)

References 16 publications

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“…This means that a rib resection is not necessary, possibly leading to pain relief and higher levels of patient comfort. Even completely minimally invasive techniques have been developed, as shown in flexible endoscopic studies (37). combining negative pressure treatment with intermittent irrigation of the wound showed promising results for achieving a sterile wound cavity (19).…”

Section: Discussionmentioning

confidence: 99%

Intrathoracic vacuum therapy for the therapy of pleural empyema—a systematic review and analysis of the literature

Stüben¹,

Plitzko²,

Reeh³

et al. 2023

J Thorac Dis

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Background: Pleural empyema is a serious and potentially deadly disease leading to a significant burden on health care systems. Conservative and surgical treatment results remain poor, with high morbidity and mortality rates. Patients with pleural empyema are often multimorbid and poor candidates for surgery.Therefore, it appears sensible to explore alternative, less invasive treatment options. Recently, the wellestablished vacuum sponge therapy has been adopted in the treatment of pleural infections. The goal of this systematic review was to identify the existing literature and reported results of vacuum therapy for pleural empyema.Methods: A systematic search of MEDLINE and the Cochrane Database was performed independently by two reviewers using predefined criteria according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. In addition, abstracts from selected conference proceedings were screened and reference scanning of the search results was performed. Single case reports were excluded.Results: Fourteen studies met the selection criteria and were reviewed. A total of 165 patients were treated with vacuum therapy in the studies reviewed. 61.2% of the patients had pleural empyema secondary to thoracic surgery. In 71.5% of the patients, vacuum therapy was applied following open window thoracostomy (OWT). Mortality rates of 0-33% were reported for vacuum therapy after OWT and 0-9.3% for vacuum therapy without OWT. Length of hospital stay (LOHS) ranged from 44-217 days for patients after OWT and could not be analysed for vacuum therapy without OWT due to lacking data. Median treatment time was 7-14 days. Treatment related complications were rare overall. Success rates defined as infection resolution were high irrespective of previous treatment and cause of empyema. Conclusions:The current literature shows that pleural vacuum therapy is a promising, safe, and feasible treatment alternative to existing treatment modalities for pleural empyema. However, the evidence for vacuum therapy without OWT is poor, and further data, optimally prospective or randomised control trials comparing the conventional surgical approach of video-assisted thoracoscopic surgery (VATS) decortication and minimally invasive vacuum therapy, are needed.

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Section: Discussionmentioning

confidence: 99%

Intrathoracic vacuum therapy for the therapy of pleural empyema—a systematic review and analysis of the literature

Stüben¹,

Plitzko²,

Reeh³

et al. 2023

J Thorac Dis

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“…Even though ENPT is well established for treatment of anastomotic leakages after colorectal surgery with a success rate of 81%, a subset of patients develops complications after termination of the therapy, such as recurrent abscess or fistula [ 7 ]. Thus, several modifications of standard ENPT have been described in literature and the necessity for individualized treatment becomes more evident [ 11 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“… “Classical” endo sponge After endoscopic exploration of the leakage and the pelvic cavity, an extraluminal, intracavitary sponge is inserted into the abscess (Endo- or Eso- Sponge ® , B. Braun Melsungen, Germany). The placement of the sponge is usually performed via an overtube, but in cases with difficult access to the abscess cavity, the drawstring method is used [ 11 ]. In small leakages with relatively clean abscesses, the sponge can be placed intraluminally at the height of the orifice to initiate collapsing of the abscess.…”

Section: Methodsmentioning

confidence: 99%

Challenges in the interdisciplinary treatment of leakages after left-sided colorectal surgery: endoscopic negative pressure therapy, open-pore film drainage therapy and beyond

Scognamiglio

Seeger

Reeh

et al. 2023

Int J Colorectal Dis

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Purpose The treatment of anastomotic leakage after left colorectal surgery remains challenging. Since its introduction, endoscopic negative pressure therapy (ENPT) has proven to be advantageous, reducing the necessity of surgical revision. The aim of our study is to present our experience with endoscopic treatment of colorectal leakages and to identify potential factors influencing treatment outcome. Methods Patients who underwent endoscopic treatment of colorectal leakage were retrospectively analyzed. Primary endpoint was the healing rate and success of endoscopic therapy. Results We identified 59 patients treated with ENPT between January 2009 and December 2019. The overall closure rate was 83%, whereas only 60% of the patients were successfully treated with ENPT and 23% needed further surgery. The time between diagnosis of leakage and uptake of endoscopic treatment did not influence the closure rate, but patients with chronic fistula (> 4 weeks) showed a significantly higher reoperation rate than those with an acute fistula (94% vs 6%, p = 0.01). Conclusion ENPT is a successful treatment option for colorectal leakages, which appears to be more favorable when started early. Further studies are still needed to better describe its healing potential, but it deserves an integral role in the interdisciplinary treatment of anastomotic leakages.

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“…Literature on ENPT of defects of the UGI consists of case reports and monocentric case series 13 – 15 , comparisons of negative pressure and stent-based therapy 16 – 18 , and descriptions of new opportunities of use 19 , 20 . We need more data about features and properties of different OPSDs used for ENPT.…”

Section: Discussionmentioning

confidence: 99%

Differences in fluid removal of different open-pore elements for endoscopic negative pressure therapy in the upper gastrointestinal tract

Jansen

Hetzel

Schulte

et al. 2022

Sci Rep

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Endoscopic negative pressure therapy is an effective treatment strategy for various defects of the gastrointestinal tract. The functional principle is based on an open-pore element, which is placed around a perforated drainage tube and connected to a vacuum source. The resulting open-pore suction device can undergo endoluminal or intracavitary placement. Different open-pore suction devices are used for endoscopic negative pressure therapy of upper gastrointestinal tract defects. Comparative analyses for features and properties of these devices are still lacking. Eight different (six hand-made devices and two commercial devices) open-pore suction devices for endoscopic negative pressure therapy of the upper gastrointestinal tract were used, amount fluid removed was evaluated. The evaluation parameters included the time to reach the target pressure, the time required to remove 100 ml of water, and the material resistance of the device. All open-pore suction devices are able to aspirate the target volume of fluids. The time to reach the target volume varied considerably. Target negative pressure was not achieved with all open-pore suction devices during the aspiration of fluids; however, there was no negative effect on suction efficiency. Of the measurement data, material resistance could be calculated for six open-pore elements. We present a simple experimental, nonphysiologically setup for open-pore suction devices used for endoscopic negative pressure therapy. The expected quantity of fluids secreted into the treated organs should affect open-pore suction device for endoscopic negative pressure therapy.

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Neue Strategien und Materialien bei der endoskopischen Vakuumtherapie im unteren Gastrointestinaltrakt

Cited by 10 publications

References 16 publications

Intrathoracic vacuum therapy for the therapy of pleural empyema—a systematic review and analysis of the literature

Intrathoracic vacuum therapy for the therapy of pleural empyema—a systematic review and analysis of the literature

Challenges in the interdisciplinary treatment of leakages after left-sided colorectal surgery: endoscopic negative pressure therapy, open-pore film drainage therapy and beyond

Differences in fluid removal of different open-pore elements for endoscopic negative pressure therapy in the upper gastrointestinal tract

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