The Dutch multicenter experience of the endo-sponge treatment for anastomotic leakage after colorectal surgery.

Surg Endosc. 2009 Jun;23(6):1379-83

Authors: van Koperen PJ, van Berge Henegouwen MI, Rosman C, Bakker CM, Heres P, Slors JF, Bemelman WA BACKGROUND: Anastomotic leakage is a feared complication following colorectal surgery and is associated with early and long-term morbidity and mortality.

The presacral cavity as the result of leakage can be treated with an endo-sponge (B-Braun Medical).

The aim of this study was to assess the effectiveness of endo-sponge treatment of the presacral cavity as the result of anastomotic leakage in the Netherlands.

METHODS: Between July 2006 and April 2008, 16 patients (M/F = 9:7) with median age 64 years (range 19-78 years) who underwent surgery for rectal cancer (n = 13) or ulcerative colitis (n = 3) were treated with the endo-sponge treatment after anastomotic leakage.

RESULTS: Of the 16 patients, eight patients started with the endo-sponge treatment within 6 weeks after the initial surgery.

In these patients the endo-sponge was placed after a median of 24 days (range 13-39 days) following surgery. In the remaining eight patients the endo-sponge treatment was started later than 6 weeks after the initial surgery.

In this group there was a median of 74 days (range 43-1,602 days) between surgery and the start of endo-sponge placement.

There was closure in six out of eight patients (75%) in the group that started with the endo-sponge treatment within 6 weeks of surgery compared with three out of eight patients (38%) in the group that started later (p = 0.315).

Closure was achieved in a median of 40 (range 28-90) days with a median number of 13 sponge replacements (range 8-17).

CONCLUSIONS: Endo-sponge placement can be helpful in the treatment for anastomotic leakage after colorectal surgery and might prevent a chronic presacral sinus. However, it is not yet clear if this new treatment modality results in quicker healing.

PMID: 19037698 [PubMed - indexed for MEDLINE]

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