Endoscopic use of EpiFix—dehydrated Human Amnion/Chorion Membrane (dHACM) allograft in patients with Gastric Leak following Sleeve Gastrectomy

Background: Bariatric surgery leaks result in significant morbidity and mortality. Experts report variable therapeutic approaches, without uniform guidelines or consensus.Objective: To review the pathogenesis, risk factors, prevention, and treatment of gastric sleeve leaks, with a focus on endoscopic approaches. In addition, the efficacy and success rates of different treatment modalities are assessed.Design: A comprehensive review was conducted using a thorough literature search of 5 online electronic databases (PubMed, PubMed Central, Cochrane, EMBASE, and Web of Science) from the time of their inception through March 2020. Studies evaluating gastric sleeve leaks were included. MeSH terms related to "endoscopic," "leak," "sleeve," "gastrectomy," "anastomotic," and "bariatric" were applied to a highly sensitive search strategy. The main outcomes were epidemiology, pathophysiology, diagnosis, treatment, and outcomes.Results: Literature search yielded 2418 studies of which 438 were incorporated into the review. Shock and peritonitis necessitate early surgical intervention for leaks. Endoscopic therapies in acute and early leaks involve modalities with a focus on one of: (i) defect closure, (ii) wall diversion, or (iii) wall exclusion. Surgical revision is required if endoscopic therapies fail to control leaks after 6 months. Chronic leaks require one or more endoscopic, radiologic, or surgical approaches for fluid collection drainage to facilitate adequate healing. Success rates depend on provider and center expertise. Conclusion:Endoscopic management of leaks post sleeve gastrectomy is a minimally invasive and effective alternative to surgery. Their effect may vary based on clinical presentation, timing or leak morphology, and should be tailored to the appropriate endoscopic modality of treatment.

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“…There is one report of a novel EpiFix-dehydrated Human Amnion/Chorion Membrane (dHACM) allograft injected endoscopically to close a leak. 275…”

Section: Tissue Adhesives and Plugsmentioning

confidence: 99%

A Comprehensive Review of Endoscopic Management of Sleeve Gastrectomy Leaks

Gjeorgjievski¹,

Imam

Cappell

et al. 2020

Journal of Clinical Gastroenterology

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“…Moreover, it contains plateletderived growth factor (PDGF) and more than 50 growth factors, cytokines and chemokines [37]. Epifix® was also used for cutaneous ulcers such as scalp ulcers [38], burns [39], gastric ulcers [40], venous leg ulcers [41] and diabetic foot ulcers [42,43].…”

Section: Human Amniotic Membrane In Other Surgical Specialitiesmentioning

confidence: 99%

Insights on the Human Amniotic Membrane in Clinical Practice with a Focus on the New Applications in Retinal Surgery

Tartaro

Caporossi

Virgili

et al. 2020

Regen. Eng. Transl. Med.

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Lay SummaryRecently, the use of the human amniotic membrane (hAM) has been extended to treat retinal disorders such as refractory macular holes, retinal breaks and dry and wet age-related macular degeneration. Not only the hAM has proved to be an excellent tool for repairing retinal tissue, but it has also shown a promising regeneration potential. This review aims to highlight the novel use of the hAM in treating retinal diseases. Although the hAM has been used in the ocular anterior segment reconstruction for more than 60 years, in the last 2 years, we have found in literature articles showing the use of the hAM in the retinal surgery field with interesting results in terms of tissue healing and photoreceptor regeneration.

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Endoscopic use of EpiFix—dehydrated Human Amnion/Chorion Membrane (dHACM) allograft in patients with Gastric Leak following Sleeve Gastrectomy

Cited by 2 publications

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A Comprehensive Review of Endoscopic Management of Sleeve Gastrectomy Leaks

A Comprehensive Review of Endoscopic Management of Sleeve Gastrectomy Leaks

Insights on the Human Amniotic Membrane in Clinical Practice with a Focus on the New Applications in Retinal Surgery

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