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Journal of Hepato-Gastroenterology

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Endo-sponge treatment of anastomotic leakage after colorectal surgery: A report of 29 cases compared to the main studies in the literature.

Author(s): Boschetti G, Moussata D*, Lahlou W, Passot G, Belkhodia H, Chauvenet M, Cotte E, Nancey S, Vaudoyer D, François Y, Desgrange C, Cabelguenne D, Benaïm S, Bourllier P, Glehen O and Flourié B

BACKGROUND: Anastomotic leakage is the main complication after colorectal surgery, inducing sepsis and often, further surgical intervention is needed. In the last few years, the vacuum-assisted closure therapy using the Endo-sponge system has been used in different types of complicated wounds and in anastomotic leakage after rectal resection. In this study, we reported our experience with Endo-sponge in leakage from colorectal anastomosis and compared it to other published series. PATIENTS AND METHODS: 29 patients with abscess or fistulas from anastomotic leakage after rectal resection or colectomy were retrospectively reviewed. The main clinical symptom was sepsis. Stoma was present at the beginning of Endo-sponge treatment in 21 patients (72% of cases). RESULTS: The mean size of the fistula was 7 ± 4.6 cm (2-20 cm). The mean time to closure of the cavity was 10 ± 6.5 weeks (2–28) and required on average 18.6 ± 13 sessions. We obtained a closure in 27 out 29 patients (93%), which were sustained in 24 out of 27 patients (89%) at 6 months. The treatment was well tolerated and performed on an outpatient basis without sedation. CONCLUSION: In our study, anastomotic leakage was treated efficiently with Endo-sponge without sedation or stoma in 31% of cases.

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