Endo-SPONGE® treatment for anastomotic leakage after colorectal surgery

Veloso, Nuno; Dinis, Maria de Lurdes; Carvalho, Manuel; Rosa, Isabel; Medeiros, Isabel; Gonçalves, Lurdes; Godinho, Rogério; Viveiros, Celeste

doi:10.1016/j.jpg.2012.08.002

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…A total of 114 publications were found. Thirty of them, published between 2006 and 2018, were considered relevant . Four were excluded because they reported overlapping cases and only the most recent series were included .…”

Section: Resultsmentioning

confidence: 99%

“…Nineteen series were finally selected for the present analysis. Overall, the quality of the included studies is loweight retrospective series [7-9,24-,28], six prospective [3,13,[29][30][31][32], the design was not reported in four [11,[33][34][35], and there was one case report [36]. Two of them were small comparative series [29,31], and three were multicentre studies [3,11,24].…”

Section: Resultsmentioning

confidence: 99%

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Endoluminal negative pressure therapy in colorectal anastomotic leaks

et al. 2019

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Aim The aim of the present work was to perform an up‐to‐date review of the literature on endoluminal negative pressure therapy for colorectal anastomotic leak. Method An electronic search in PubMed and Google Scholar and a manual search without language restrictions were performed on 25 January 2019. Only original series reporting endoluminal negative pressure therapy in colorectal anastomotic leaks were included. The primary outcome was the success rate (complete closure of the abscess cavity). The secondary outcomes were the rates of complications and stoma closure. Results Nineteen series with a total of 295 cases were analysed. The median distance of the anastomosis from the anal verge and the size of the abscess were 5.65 cm (4.9–10) and 6.0 cm (5–8.1) respectively. In 84.5% (78%–91%) the stoma was created at the first intervention. Neoadjuvant therapy was performed in 48.6% (3%–60%). Median 7 sponges (2–34) were used with median negative pressure 150 mmHg (125–700) for a median of 31 days (14–127). The success rate was 85.4% (80%–91%) with ileostomy closure in 72.6%. Complications were observed in 19% (13%–25%): abscesses 11.5% and anastomotic stenosis 4.4%. Laparotomy was required in 15% of the complications. The stoma was the only significant predictor for the success of the therapy (0.007, SE 0.004, P = 0.040). Conclusions The initial experience looks promising with an 85% success rate, which precludes risky re‐resections with redo anastomosis or Hartmann's procedure. Despite the good initial results, definitive conclusions cannot be drawn because of the small sample size and the lack of high‐quality comparative studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Endoluminal negative pressure therapy in colorectal anastomotic leaks

et al. 2019

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“…After performing literature search we identified 12 articles, where endoluminal negative pressure was used for treatment of anastomotic leakage after rectal surgery. [9][10][11][12][13][14][15][16][17][18][19][20] These papers are summarized in table I. The number of treated patients in all but two papers are low (1-5 patients) in exception for two papers by Weidenhagen et al both published in 2008, where 60 ad 34 patients were described respectively.…”

Section: Resultsmentioning

confidence: 99%

“…The work, that is presented in both papers, in collaboration with "BBraun Melsungen AG, Germany" led to the development of EndoSPONGE technique and inventory. Arezzo et al 16 and Veloso et al 17 both show the efficacy of EndoSPONGE treatment of patients with anastomosis leakage after lower anterior colon resection. In both papers, all patients were successfully managed with this technique.…”

Section: Discussionmentioning

confidence: 97%

Endoluminal negative pressure wound treatment of anastomotic leakage in rectal surgery patients – critical review of the literature.

Huľo

2015

NPWTJ

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During past 20 years the use of negative pressure wound therapy (NPWT) has shown it effectivity and efficiency in treatment of different indications. These indications include treatment of septic complications of open surgery (open abdomen, enteroatmospheric fistulas, wound dehiscence including sternotomy infections, staged abdominal wall repair, diabetic foot syndrome, and salvage of infected prosthetic material) or their prevention (prevention of complications in skin graft application and prevention of prosthetic graft infection). Such use consists of either external use directly in the wound, or intracorporal applications (intraabdominal NPWT, intrathoracal NPWT). New approaches and ways of application are evolving. One of new therapeutic methods are endoluminal use in both upper and lower gastrointestinal tract. Authors performed and present thorough review of the literature on use of endoluminal NPWT in anastomotic leakage in rectal surgery patients. Authors conclude, that endo NPWT is becoming a new and effective therapeutic method in treatment of septic complications of patients after rectal surgery.

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“…Anastomotic leakage is a serious and life-threatening adverse event associated with increased morbidity and mortality after anterior resection of the rectum. 1 Broad-spectrum antibiotic coverage and percutaneous drainage is an option in conservative treatment for stable patients. Patients with peritonitis usually require surgical treatment with diverting stoma.…”

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confidence: 99%