Endo-sponge therapy for management of anastomotic leakages after colorectal surgery: A case series and review of literature

Giuseppe Strangio, Angelo Zullo, Elisa Chiara Ferrara, Andrea Anderloni, Alessandra Carlino, Manol Jovani, Camilla Ciscato, Cesare Hassan, Alessandro Repici

Research output: Contribution to journalArticle

Abstract

Background: Endo-sponge treatment is a novel approach to manage selected patients with anastomotic leakage following colorectal surgery. However, the available data are still scanty. Aims: To evaluate the efficacy and safety of the endo-sponge therapy in a large series, and to perform a review of the current evidence concerning such a treatment. Methods: Consecutive patients diagnosed with partial colonic anastomotic leakage managed with endo-sponge placement were enrolled. The endo-sponge system was changed every 48-72. h as outpatient, until to cavity closure. Literature review was performed for pooled-data analysis. Results: Twenty-five patients were enrolled, including 13 (52%) with diverting ileostomy. Following endo-sponge applications (median sessions: 9, range: 1-39; median treatment duration: 4 weeks, range: 1-32), a complete healing was achieved in 22 (88%) patients. Three (12%) patients developed a major complication (1 uretheric fistula, 1 ileal fistula, and 1 pararectal abscess), all successfully treated by surgery. Ileostomy closure was achieved in 11 (84.6%) patients. No mortality related to the procedure was observed. Overall, 174 patients treated with endo-sponge were reported in literature. By considering data of the larger 7 studies, a complete healing of presacral cavity was achieved in 131 (94.3%) out of 149 patients. Conclusions: Our relatively large series of patients confirmed the efficacy, tolerability, and an acceptably low complication rate of endo-sponge therapy for colorectal anastomosis leakage treatment.

Original languageEnglish
Pages (from-to)465-469
Number of pages5
JournalDigestive and Liver Disease
Volume47
Issue number6
DOIs
Publication statusPublished - Jun 1 2015

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Keywords

  • Anastomotic leakage
  • Colon surgery
  • Endo-sponge
  • Endoscopic treatment

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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