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

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

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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical / adverse effects
  • Anastomotic Leak / therapy*
  • Colon / surgery*
  • Colonoscopy / methods*
  • Colorectal Surgery / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Rectum / surgery*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Vacuum