| Autor: |
Kühn, Florian, Zimmermann, Julia, Beger, Nicola, Wirth, Ulrich, Hasenhütl, Sandro M., Drefs, Moritz, Chen, Chen, Burian, Maria, Karcz, W. Konrad, Rentsch, Markus, Werner, Jens, Schiergens, Tobias S. |
| Zdroj: |
Surgical Endoscopy & Other Interventional Techniques; Apr2021, Vol. 35 Issue 4, p1749-1754, 6p |
| Abstrakt: |
Background: Symptomatic rectal stump leakage (RSL) is a serious complication after discontinuity resection and requires immediate surgical, interventional, or endoscopic therapy. Re-operations are associated with high morbidity and mortality in these mostly very ill patients. Endoscopic vacuum therapy (EVT) has been established for management of anastomotic leakage; however, its effectiveness for RSL treatment has not been analyzed in detail yet.Methods: A retrospective analysis of patients treated with EVT for RSL between 2001 and 2018 analyzing factors predicting therapy success and duration was carried out.Results: Fifty-six patients with RSL at a median age of 66 years were included. Of these, 18 patients (32%) had been referred for EVT from external departments or institutions. RSL was associated with a relevant clinical deterioration in all patients, and 55 patients (98%) had been classified as ASA 3 and 4, preoperatively. In 9 patients (16%), additional surgical revision was necessary with initiation of EVT. In 47 patients (84%), EVT was successful and local control of the inflammatory focus was achieved. The median duration of therapy was 20 days. Two patients (4%) suffered from minor EVT-associated bleeding that was endoscopically controlled. Preoperative radiation of the pelvis was significantly associated with EVT failure (P = 0.035), whereas patient age represented a predictive factor for therapy length (P = 0.039). In 12 patients (21%), restoration of intestinal continuity was achieved in the further course.Conclusions: We present the first specific series on EVT for RSL. EVT for RSL was shown to be an effective and safe minimal-invasive treatment option, avoiding surgical revision in the majority of patients. [ABSTRACT FROM AUTHOR] |
| Databáze: |
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