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Dig Liver Dis. 2015 Apr;47(4):342-5. doi: 10.1016/j.dld.2014.12.003. Epub 2014 Dec 17.

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

Author information

1
Department of Surgical Sciences, University of Torino, Italy. Electronic address: alberto.arezzo@unito.it.
2
Department of Surgical Sciences, University of Torino, Italy.

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.

KEYWORDS:

Anastomotic leak; Colorectal surgery; Endoscopic vacuum; Postoperative complications

PMID:
25563812
DOI:
10.1016/j.dld.2014.12.003
[Indexed for MEDLINE]

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