Management of colorectal anastomotic leakage using endoscopic negative pressure therapy with or without protective ostomy: a retrospective study
| العنوان: | Management of colorectal anastomotic leakage using endoscopic negative pressure therapy with or without protective ostomy: a retrospective study |
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| المؤلفون: | Flavius Sandra-Petrescu, Christoph Reissfelder, Georg Kähler, Florian Herrle, Emmanouil Tzatzarakis |
| المصدر: | International Journal of Colorectal Disease |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Ostomy, Colorectal anastomosis, Anastomotic Leak, Asymptomatic, Group B, Colorectal surgery, Internal medicine, Antibiotic therapy, medicine, Humans, Retrospective Studies, Management algorithm, business.industry, Anastomosis, Surgical, Gastroenterology, Retrospective cohort study, Lack of protective ostomy, Hepatology, Surgery, Anastomotic leakage, Original Article, Leak, medicine.symptom, Colorectal Neoplasms, business, Vacuum therapy |
| الوصف: | Purpose Management of colorectal anastomotic leakage (AL) is patient-oriented and requires an interdisciplinary approach. We analyzed the management of AL according to its severity and presence of ostomy and proposed a therapy algorithm. Methods We identified all patients who underwent colorectal surgery and developed an AL in our clinic between 2012 and 2017. The management of AL was retrospectively analyzed according to the severity grade: asymptomatic (A), requesting interventional or antibiotic therapy (B), undergoing re-operation (C). The groups were compared according to the leakage characteristics, presence of ostomy, and patient clinical conditions. Results We identified 784 consecutive patients meeting the inclusion criteria. Of these, 10.8% experienced an AL (A = 18%, B = 48%, and C = 34%). The rate of successful ostomy closure was 100% (A), 68% (B), and 62% (C), respectively. Within group B, 91% of the patients were treated solely by endoscopic negative pressure therapy (ENPT), whereas 37% of the patients within group C required ENPT in addition to surgery. Seven cases within group B (17%) required no protective ostomy (nOB) during ENPT which was itself shorter and required less cycles in comparison to group B with ostomy (OB) (p = 0.017 and 0.111, respectively). Moreover, the leakage distance to anal verge was higher in the OB subgroup (p Conclusion ENPT for the treatment of colorectal AL is efficient in combination with operative revision or protective ostomy. In selected patients, it is feasible also in the absence of a protective ostomy. |
| تدمد: | 1432-1262 0179-1958 |
| DOI: | 10.1007/s00384-021-04011-8 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fbfc9ca14a290a596f13245d9007ff6e https://doi.org/10.1007/s00384-021-04011-8 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....fbfc9ca14a290a596f13245d9007ff6e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14321262 01791958 |
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| DOI: | 10.1007/s00384-021-04011-8 |