Endo-vacuum assisted closure treatment for rectal anastomotic insufficiency
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Endo-vacuum assisted closure treatment for rectal anastomotic insufficiency. / Mees, Soeren Torge; Palmes, Daniel; Mennigen, Rudolf; Senninger, Norbert; Haier, Joerg; Bruewer, Matthias.
in: DIS COLON RECTUM, Jahrgang 51, Nr. 4, 04.2008, S. 404-10.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Endo-vacuum assisted closure treatment for rectal anastomotic insufficiency
AU - Mees, Soeren Torge
AU - Palmes, Daniel
AU - Mennigen, Rudolf
AU - Senninger, Norbert
AU - Haier, Joerg
AU - Bruewer, Matthias
PY - 2008/4
Y1 - 2008/4
N2 - BACKGROUND: Anastomotic insufficiency in patients with colorectal anastomosis is a major complication with high morbidity and mortality. Local treatment with transrectal lavage and drainage can be considered in patient without peritonitis. In order to prevent prolonged wound closure and secondary complications during conservative treatment we investigated the vacuum assisted closure (VAC) in this setting.METHODS: Ten patients with anastomotic insufficiency after colorectal resections, who did not require transabdominal interventions, were treated with an Endo-vacuum assisted closure dressing (Group A; n = 5) or by transrectal lavage (Group B; n = 5). Time for wound healing, duration of hospitalization and pain assessment were compared in both groups.RESULTS: The Endo-vacuum assisted closure treatment was performed for a median time of 27 days without any vacuum assisted closure associated complications. Wound healing was significantly accelerated in Group A compared to Group B. Time in hospital was slightly shortened in patients with Endo-vacuum assisted closure. Pain assessment in both groups did not show any significant differences.CONCLUSION: Endo-vacuum assisted closure therapy is a novel approach that can be considered in diverted patients with failed colorectal anastomoses. Larger randomized trials that include complete cost-benefit analyses are needed to establish its role in this setting.
AB - BACKGROUND: Anastomotic insufficiency in patients with colorectal anastomosis is a major complication with high morbidity and mortality. Local treatment with transrectal lavage and drainage can be considered in patient without peritonitis. In order to prevent prolonged wound closure and secondary complications during conservative treatment we investigated the vacuum assisted closure (VAC) in this setting.METHODS: Ten patients with anastomotic insufficiency after colorectal resections, who did not require transabdominal interventions, were treated with an Endo-vacuum assisted closure dressing (Group A; n = 5) or by transrectal lavage (Group B; n = 5). Time for wound healing, duration of hospitalization and pain assessment were compared in both groups.RESULTS: The Endo-vacuum assisted closure treatment was performed for a median time of 27 days without any vacuum assisted closure associated complications. Wound healing was significantly accelerated in Group A compared to Group B. Time in hospital was slightly shortened in patients with Endo-vacuum assisted closure. Pain assessment in both groups did not show any significant differences.CONCLUSION: Endo-vacuum assisted closure therapy is a novel approach that can be considered in diverted patients with failed colorectal anastomoses. Larger randomized trials that include complete cost-benefit analyses are needed to establish its role in this setting.
KW - Adult
KW - Aged
KW - Anastomosis, Surgical
KW - Equipment Design
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Rectal Diseases
KW - Rectum
KW - Reoperation
KW - Suction
KW - Treatment Failure
KW - Vacuum
U2 - 10.1007/s10350-007-9141-z
DO - 10.1007/s10350-007-9141-z
M3 - SCORING: Journal article
C2 - 18197452
VL - 51
SP - 404
EP - 410
JO - DIS COLON RECTUM
JF - DIS COLON RECTUM
SN - 0012-3706
IS - 4
ER -
