BACKGROUND/AIM: Anastomotic leakage (AL) after anterior resection for rectal cancer occurs in up to 26% of patients. In the last decade, endoscopic vacuum therapy (EVT) has gained interest as a treatment option for AL. This study aimed to compare the clinical success rate of EVT versus transanal drainage (TD) in AL treatment and investigate whether the frequency of bowel continuity differed. PATIENTS AND METHODS: Patients treated for rectal cancer at the Skåne University Hospital, Sweden between 2009-2018 were identified through the Swedish Colorectal Cancer Registry (SCRCR). Patient characteristics, operative and AL data were retrieved by SCRCR and chart review. RESULTS: Out of 1,095 patients subjected to rectal cancer surgery, 361 patients had undergone anterior resection. AL occurred in 39 patients, of these 14 patients were treated with EVT and 17 with TD. Bowel continuity was achieved in 50% of patients treated with EVT and 65% of patients treated with TD (p=0.28). The patients were under treatment for a median period of 24.5 days (IQR=11-36 days) when treated with EVT and 37 days (IQR=17-51 days) with TD. CONCLUSION: No superiority of EVT treatment could be shown in restoring bowel continuity. This questions the role of EVT in AL treatment after anterior resection.
BACKGROUND/AIM: Anastomotic leakage (AL) after anterior resection for rectal cancer occurs in up to 26% of patients. In the last decade, endoscopic vacuum therapy (EVT) has gained interest as a treatment option for AL. This study aimed to compare the clinical success rate of EVT versus transanal drainage (TD) in AL treatment and investigate whether the frequency of bowel continuity differed. PATIENTS AND METHODS: Patients treated for rectal cancer at the Skåne University Hospital, Sweden between 2009-2018 were identified through the Swedish Colorectal Cancer Registry (SCRCR). Patient characteristics, operative and AL data were retrieved by SCRCR and chart review. RESULTS: Out of 1,095 patients subjected to rectal cancer surgery, 361 patients had undergone anterior resection. AL occurred in 39 patients, of these 14 patients were treated with EVT and 17 with TD. Bowel continuity was achieved in 50% of patients treated with EVT and 65% of patients treated with TD (p=0.28). The patients were under treatment for a median period of 24.5 days (IQR=11-36 days) when treated with EVT and 37 days (IQR=17-51 days) with TD. CONCLUSION: No superiority of EVT treatment could be shown in restoring bowel continuity. This questions the role of EVT in AL treatment after anterior resection.
Authors: Nuh N Rahbari; Jürgen Weitz; Werner Hohenberger; Richard J Heald; Brendan Moran; Alexis Ulrich; Torbjörn Holm; W Douglas Wong; Emmanuel Tiret; Yoshihiro Moriya; Søren Laurberg; Marcel den Dulk; Cornelis van de Velde; Markus W Büchler Journal: Surgery Date: 2009-12-11 Impact factor: 3.982
Authors: Wernard A A Borstlap; Emma Westerduin; Tjeerd S Aukema; Willem A Bemelman; Pieter J Tanis Journal: Ann Surg Date: 2017-11 Impact factor: 12.969