Author:
Scognamiglio Pasquale,Seeger Anja,Reeh Matthias,Melling Nathaniel,Karstens Karl F,Rösch Thomas,Izbicki Jakob R,Kantowski Marcus,Tachezy Michael
Abstract
Abstract
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.
Funder
Universitätsklinikum Hamburg-Eppendorf (UKE)
Publisher
Springer Science and Business Media LLC
Reference28 articles.
1. Thomas MS, Margolin DA (2016) Management of colorectal anastomotic leak. Clin Colon Rectal Surg 29(2):138–144
2. Qu H, Liu Y, Bi DS (2015) Clinical risk factors for anastomotic leakage after laparoscopic anterior resection for rectal cancer: a systematic review and meta-analysis. Surg Endosc 29(12):3608–3617
3. Sparreboom CL, van Groningen JT, Lingsma HF, Wouters M, Menon AG, Kleinrensink GJ et al (2018) Different risk factors for early and late colorectal anastomotic leakage in a nationwide audit. Dis Colon Rectum 61(11):1258–66
4. Rahbari NN, Weitz J, Hohenberger W, Heald RJ, Moran B, Ulrich A et al (2010) Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery 147(3):339–351
5. Weidenhagen R, Grutzner K, Weilbach C, Speisberg F, Schildberg F (2003) Endoscopic vacuum assisted closure of anastomotic leakage after anterior resection of the rectum - a new method. Surg Endosc 17(S92)
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献