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Surgical Endoscopy

Published in:

01-08-2008

Endoscopic vacuum-assisted closure of anastomotic leakage following anterior resection of the rectum: a new method

Authors: Rolf Weidenhagen, Klaus Uwe Gruetzner, Timm Wiecken, Fritz Spelsberg, Karl-Walter Jauch

Published in: Surgical Endoscopy | Issue 8/2008

Abstract

Background

Conservative treatment of anastomotic leakage after anterior resection of the rectum seems to be possible in patients who have no occurrence of generalized peritonitis. This report describes a new method of endoscopic management of large anastomotic leakage in these patients.

Method

The main feature of this new method is the endoscopically assisted placement of an open-cell sponge connected to a vacuum device into the abscess cavity via an introducer device. The sponge system is changed every 48–72 h.

Results

Twenty-nine patients with an anastomotic leakage after anterior resection were treated with the endoscopic vacuum therapy. The total duration of endovac therapy was 34.4 ± 19.4 days. The total number of endoscopic sessions per patient was 11.4 ± 6.3. In 21 of the 29 patients, a protecting stoma was created at the primary operation. Four patients were treated successfully without the need of a secondary stoma. Definitive healing was achieved in 28 of the 29 patients.

Conclusions

Endoscopic vacuum-assisted closure is a new efficacious modality for treating anastomotic leakage following anterior resection due to an effective control of the septic focus. Further studies will show if it is possible to reduce the high mortality rate of patients with anastomotic leakage through the avoidance of surgical reinterventions while at the same time preserving the sphincter function.

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Title: Endoscopic vacuum-assisted closure of anastomotic leakage following anterior resection of the rectum: a new method
Authors: Rolf Weidenhagen
Klaus Uwe Gruetzner
Timm Wiecken
Fritz Spelsberg
Karl-Walter Jauch
Publication date: 01-08-2008
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 8/2008
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-007-9706-x

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Endoscopic vacuum-assisted closure of anastomotic leakage following anterior resection of the rectum: a new method

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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