PURPOSE: The purpose of the study was to prospectively assess the impact of neoadjuvant radiochemotherapy on the formation of major anastomotic rectal leaks and treatment by endoscopic transanal vacuum-assisted rectal drainage (ETVARD). MATERIALS AND METHODS: Twenty six patients with malignancies with rectal anastomotic leaks were prospectively treated, including 14 of 26 patients following neoadjuvant radiochemotherapy. ETVARD was the first-line treatment. RESULTS: In 23 of 26 patients, ETVARD was successfully completed. In patients following neoadjuvant radiochemotherapy sizes of leakage cavities, duration of ETVARD, number of sponge exchanges, and endoscopies as well as time to closure of cavities were significantly increased (0.009 < p < 0.035) compared to patients after primary surgery. Increased age showed similar correlations, whereas the level of anastomoses did not influence these parameters. Patients without (ile)ostomies could also be treated by ETVARD. Follow-up endoscopies have not shown any major changes. CONCLUSIONS: Radiochemotherapy has a significant impact on development and treatment of major anastomotic rectal leaks. Most patients can be successfully treated by ETVARD, avoiding additional resective surgery or permanent (col)ostomies.
PURPOSE: The purpose of the study was to prospectively assess the impact of neoadjuvant radiochemotherapy on the formation of major anastomotic rectal leaks and treatment by endoscopic transanal vacuum-assisted rectal drainage (ETVARD). MATERIALS AND METHODS: Twenty six patients with malignancies with rectal anastomotic leaks were prospectively treated, including 14 of 26 patients following neoadjuvant radiochemotherapy. ETVARD was the first-line treatment. RESULTS: In 23 of 26 patients, ETVARD was successfully completed. In patients following neoadjuvant radiochemotherapy sizes of leakage cavities, duration of ETVARD, number of sponge exchanges, and endoscopies as well as time to closure of cavities were significantly increased (0.009 < p < 0.035) compared to patients after primary surgery. Increased age showed similar correlations, whereas the level of anastomoses did not influence these parameters. Patients without (ile)ostomies could also be treated by ETVARD. Follow-up endoscopies have not shown any major changes. CONCLUSIONS: Radiochemotherapy has a significant impact on development and treatment of major anastomotic rectal leaks. Most patients can be successfully treated by ETVARD, avoiding additional resective surgery or permanent (col)ostomies.
Authors: Sang Hun Jung; Chang Sik Yu; Pyong Wha Choi; Dae Dong Kim; In Ja Park; Hee Cheol Kim; Jin Cheon Kim Journal: Dis Colon Rectum Date: 2008-04-12 Impact factor: 4.585
Authors: B Lefebure; J J Tuech; V Bridoux; B Costaglioli; M Scotte; P Teniere; F Michot Journal: Int J Colorectal Dis Date: 2007-09-02 Impact factor: 2.571
Authors: Guillaume Martel; Youssuf Al-Suhaibani; Husein Moloo; Fatima Haggar; Martin Friedlich; Joseph Mamazza; Eric C Poulin; Hartley Stern; Robin P Boushey Journal: Dis Colon Rectum Date: 2008-06-04 Impact factor: 4.585
Authors: T Welsch; S A Müller; A Ulrich; A Kischlat; U Hinz; P Kienle; M W Büchler; J Schmidt; B M Schmied Journal: Int J Colorectal Dis Date: 2007-07-17 Impact factor: 2.571
Authors: Sami A Chadi; Abe Fingerhut; Mariana Berho; Steven R DeMeester; James W Fleshman; Neil H Hyman; David A Margolin; Joseph E Martz; Elisabeth C McLemore; Daniela Molena; Martin I Newman; Janice F Rafferty; Bashar Safar; Anthony J Senagore; Oded Zmora; Steven D Wexner Journal: J Gastrointest Surg Date: 2016-09-16 Impact factor: 3.452
Authors: Angela Fischer; Ignazio Tarantino; René Warschkow; Jochen Lange; Andreas Zerz; Franc H Hetzer Journal: Int J Colorectal Dis Date: 2010-02-03 Impact factor: 2.571
Authors: Alaa Alakkari; Ruchit Sood; Simon M Everett; Bjorn J Rembacken; Jeremy Hayden; Abeezar Sarela; Noor Mohammed Journal: Frontline Gastroenterol Date: 2019-01-12
Authors: Stefan Riss; Anton Stift; Caroline Kienbacher; Bernhard Dauser; Ingrid Haunold; Stefan Kriwanek; Wolfgang Radlsboek; Michael Bergmann Journal: World J Gastroenterol Date: 2010-09-28 Impact factor: 5.742
Authors: Bodo Schniewind; Clemens Schafmayer; Gesa Voehrs; Jan Egberts; Witigo von Schoenfels; Tobias Rose; Roland Kurdow; Alexander Arlt; Mark Ellrichmann; Christian Jürgensen; Stefan Schreiber; Thomas Becker; Jochen Hampe Journal: Surg Endosc Date: 2013-05-25 Impact factor: 4.584
Authors: Maciej Borejsza-Wysocki; Krzysztof Szmyt; Adam Bobkiewicz; Stanisław Malinger; Józef Świrkowicz; Jacek Hermann; Michał Drews; Tomasz Banasiewicz Journal: Wideochir Inne Tech Maloinwazyjne Date: 2015-06-08 Impact factor: 1.195