Aim: Anastomotic leaks after ileal pouch-anal anastomoses (IPAA) are challenging complications. Previous reports showed that the Endoluminal Vacuum-assisted Closure Therapy (Endo-sponge) is effective only when followed by the surgical closure of the defect. The aim of the study is to analyse the outcomes of the Endo-sponge as a unique treatment for IPAA leaks. Method: Consecutive cases of IPAA leaks were prospectively enrolled. All patients had an ileostomy. The Endo-sponge was replaced every 48–72 h until the cavity reduced in size and showed healthy granulation tissue. The residual defect was left in situ and checked through outpatient endoscopies at a weekly basis for at least 6 weeks. The success was defined as the progressive decrease of the cavity size. Results: Four patients underwent the treatment after a median of 6.5 (6–49) days from the diagnosis of leak. The median duration of treatment was 8 days (3–33), requiring an average of 3.5 (3.7) replacements of the device. No perioperative complication was recorded. The progressive healing of the cavity was documented in all cases and no recurrence was observed at a follow-up of 6 months. Conclusion: Our preliminary results showed that Endo-sponge is safe and effective as an unique treatment for IPAA leaks.

P071 Endoluminal vacuum-assisted closure therapy for the treatment of ileal pouch-anal anastomosis leaks: a pilot study (12th Scientific and Annual Meeting of the European Society of Coloproctology, 20–22 September 2017, CityCube, Berlin, Germany)

M. Rottoli;M. P. Di Simone;C. Vallicelli;G. Liguori;VITTORI, LAURA;G. Poggioli
2017

Abstract

Aim: Anastomotic leaks after ileal pouch-anal anastomoses (IPAA) are challenging complications. Previous reports showed that the Endoluminal Vacuum-assisted Closure Therapy (Endo-sponge) is effective only when followed by the surgical closure of the defect. The aim of the study is to analyse the outcomes of the Endo-sponge as a unique treatment for IPAA leaks. Method: Consecutive cases of IPAA leaks were prospectively enrolled. All patients had an ileostomy. The Endo-sponge was replaced every 48–72 h until the cavity reduced in size and showed healthy granulation tissue. The residual defect was left in situ and checked through outpatient endoscopies at a weekly basis for at least 6 weeks. The success was defined as the progressive decrease of the cavity size. Results: Four patients underwent the treatment after a median of 6.5 (6–49) days from the diagnosis of leak. The median duration of treatment was 8 days (3–33), requiring an average of 3.5 (3.7) replacements of the device. No perioperative complication was recorded. The progressive healing of the cavity was documented in all cases and no recurrence was observed at a follow-up of 6 months. Conclusion: Our preliminary results showed that Endo-sponge is safe and effective as an unique treatment for IPAA leaks.
Rottoli, Matteo; DI SIMONE, MASSIMO PIERLUIGI; Vallicelli, Carlo; Liguori, Giuseppina; Vittori, Laura; Poggioli, Gilberto
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/612264
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