The effect of endoscopic treatment on healing of anastomotic leaks after anterior resection of rectal cancer

Chopra, Sascha; Mrak, Karl; Hünerbein, M.

doi:10.1016/j.surg.2008.09.012

Cited by 57 publications

(48 citation statements)

References 25 publications

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“…En effet, le contrôle de l'infection et du trajet fistuleux semble acquis plus rapidement lorsqu'un geste endoscopique est réalisé, parfois en association à une stomie. Cette donnée constatée chez nos patients est retrouvée dans des circonstances similaires dans la litté-rature [3]. L'idéal, comme toujours, serait la réalisation d'une étude contrôlée.…”

Section: Resultsunclassified

“…Les fistules colo-vaginales ont été exclues car le trajet est court ; les pressions régnant de part et d'autre de la fistule ne permettent pas une obturation stable par le bouchon de colle. Il en est de même pour les fistules de grand diamètre qui relèvent plus probablement de la mise en place d'un drainage aspiratif [3]. Enfin, la persistance d'une cavité suppurée en amont du trajet fistuleux, se drainant par son intermédiaire, fait prendre le risque de l'apparition d'une suppuration abcédée sévère, comme cela a été décrit pour les fistules anales.…”

Section: Discussionunclassified

“…Cette complication induit une morbidité propre : dégradation des résultats fonctionnels, augmentation du taux de sténose anastomotique et de récidive tumorale, mortalité spéci-fique, retard dans la mise en route des traitements complé-mentaires, nécessité de mise en place secondaire d'une stomie avec ses propres conséquences. Cette morbidité est notamment liée au traitement chirurgical classique associant un drainage chirurgical et la mise en place d'une déri-vation fécale si elle n'avait pas été réalisée lors de l'intervention initiale [3].…”

Section: Introductionunclassified

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Traitement par colle biologique des fistules postopératoires en chirurgie colorectale

et al. 2009

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Section: Resultsunclassified

Section: Discussionunclassified

Section: Introductionunclassified

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Traitement par colle biologique des fistules postopératoires en chirurgie colorectale

et al. 2009

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“…The use of SEPS in human studies has been reported in few patients to seal anastomotic leaks < 2 cm in the mid-rectum, with favorable outcomes [107,119].…”

Section: Stentmentioning

confidence: 99%

“…Recent studies have demonstrated the possibility of endoscopic closure [103][104][105][106]39,107,108].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic “rescue” treatment for gastrointestinal perforations, anastomotic dehiscence and fistula

Dabizzi

Ceglie²,

Baig

et al. 2016

Clinics and Research in Hepatology and Gastroenterology

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Systematic review of endoluminal vacuum‐assisted therapy as salvage treatment for rectal anastomotic leakage

et al. 2018

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Background Endoluminal vacuum‐assisted therapy (EVT) has been introduced recently to treat colorectal anastomotic leakage. The aim of this study was to evaluate the safety and efficacy of EVT in the treatment of anastomotic leakage and rectal stump insufficiency after Hartmann's procedure. Methods A systematic search of MEDLINE, Scopus and Cochrane databases was performed using search terms related to EVT and anastomotic leakage or rectal stump insufficiency in line with the PRISMA checklist. Observational studies, RCTs and case series studies published to July 2017 were included. Primary outcomes of the review were the success of EVT, defined as complete or partial healing of the anastomotic defect and associated cavity, and the rate of stoma reversal after EVT. Secondary outcomes included the duration of treatment to complete healing, complications of treatment and the need for further intervention. A meta‐analysis was conducted. The potential effect of clinical confounders on the failure of EVT was investigated using the random‐effects meta‐regression model. Results Of 476 articles identified, 17 studies reporting on 276 patients were ultimately included. The weighted mean rate of success was 85·3 (95 per cent c.i. 80·1 to 90·5) per cent, with a median duration from inception of EVT to complete healing of 47 (range 40–105) days. The weighted mean rate of stoma reversal across the studies was 75·9 (64·6 to 87·2) per cent. Twenty‐five patients (9·1 per cent) required additional interventions after EVT. Thirty‐eight patients (13·8 per cent) developed complications. The weighted mean complication rate across the studies was 11·1 (6·0 to 16·2) per cent. Variables significantly associated with failure included preoperative radiotherapy, absence of diverting stoma, complications and male sex. Conclusion EVT is associated with a high rate of complete healing of anastomotic leakage and stoma reversal. It is an effective option in appropriately selected patients with anastomotic leakage.

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The effect of endoscopic treatment on healing of anastomotic leaks after anterior resection of rectal cancer

Cited by 57 publications

References 25 publications

Traitement par colle biologique des fistules postopératoires en chirurgie colorectale

Traitement par colle biologique des fistules postopératoires en chirurgie colorectale

Endoscopic “rescue” treatment for gastrointestinal perforations, anastomotic dehiscence and fistula

Systematic review of endoluminal vacuum‐assisted therapy as salvage treatment for rectal anastomotic leakage

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