Endoluminální vakuová terapie v léčbě prosakování anastomózy po přední resekci rekta
Authors:
R. Weidenhagen 1; K. U. Gruetzner 2; T. Wiecken 1; F. Spelsberg 1; Jauch K.-W. 1
Authors‘ workplace:
Department of Surgery Klinikum Grosshadern Ludwig-Maximilian-University of Munich, Munich, Germany
1; Clinic for Visceral-, Vascular and Transplant Surgery Chair of Surgery I, University Witten/Herdecke Clinic Cologne-Merheim, Cologne, Germany
2
Published in:
Rozhl. Chir., 2008, roč. 87, č. 8, s. 397-402.
Category:
Monothematic special - Original
Overview
Anastomotic leakage is the most important complication after (deep) anterior rectal resection, and is the main cause for the high level of patient mortality and morbidity [1-5]. It can lead to generalized peritonitis, with a severe septic progression involving multiple organ failure and potentially culminating in the death of the patient. Despite numerous improvements in the surgical technique, it has so far not been possible to reduce the leakage rate significantly [6, 7]. An innovative endoscopic method for treating anastomotic leakage has now been developed and established clinically at the Department of Surgery, University of Munich - Großhadern [8]. Working together with B. Braun, we have been able to develop the technique of endoluminal vacuum therapy further into the Endo-SPONGE treatment, and prepare it as an autonomous therapeutic method. In the following report we present our experiences to date in the area of endoluminal vacuum therapy.
Key words:
endoluminal vacuum therapy – anastomotic leakage – rectal resection
Sources
1. Hallböök, O., Sjodahl, R. Anastomotic leakage and functional outcome after anterior resection of the rectum. Br. J. Surg., 1996; 83: 60–62.
2. Heald, R. J., Karanjia, N. D. Results of radical surgery for rectal cancer. World J. Surg., 1992; 16: 848–857.
3. Schrock, T. R., Deveney, C. W., Dunphy, J. E. Factor contributing to leakage of colonic anastomoses. Ann. Surg., 1973; 177: 513–518.
4. Goligher, J. C., Graham, N. G., De Dombal, F. T. Anastomotic dehiscence after anterior resection of rectum and sigmoid. Br. J. Surg., 1970; 57: 108–109.
5. Mileski, W. J., Joehl, R. J., Rege, R. V., Nahrwold, D. L. Treatment of anastomotic leakage following low anterior colon resection. Arch. Surg., 1988; 123: 968–971.
6. Pakkastie, T. E., Luukkonen, P. E., Jarvinen, H. J. Anastomotic leakage after anterior resection of the rectum. Eur. J. Surg., 1994; 160: 293–297; discussion 299–230.
7. Ravo, B. Colorectal anastomotic healing and intracolonic bypass procedure. Surg. Clin. North Am. JID - 0074243 1988; 68: 1267–1294.
8. Weidenhagen, R., Gruetzner, K., Weilbach, C., Spelsberg, F., Schildberg, F. Endoscopic vacuum assisted closure of anastomotic leakage after anterior resection of the rectum – a new method. Surg. Endosc., 2003; 17: S92.
9. Fielding, L. P., Stewart-Brown, S., Blesovsky, L., Kearney, G. Anastomotic integrity after operations for large-bowel cancer: a multicentre study. Br. Med. J., 1980; 281: 411–.
10. Graf, W., Glimelius, B., Bergstrom, R., Pahlman, L. Complications after double and single stapling in rectal surgery. Eur. J. Surg., 1991; 157: 543–547.
11. Tuson, J. R., Everett, W. G. A retrospective study of colostomies, leaks and strictures after colorectal anastomosis. Int. J. Colorectal. Dis., 1990; 5: 44–48.
12. Gastinger, I., Marusch, F., Steinert, R., Wolff, S., Koeckerling, F., Lippert, H., CN - WG’C Protective defunctioning stoma in low anterior resection for rectal carcinoma. Br. J. Surg., 2005; 92: 1137–1142.
13. Cade, D., Gallagher, P., Schofield, P. F., Turner, L. Complications of anterior resection of the rectum using the EEA stapling device. Br. J. Surg., 1981; 68: 339–340.
14. Heald, R. J., Leicester, R. J. The low stapled anastomosis. Br. J. Surg., 1981; 68: 333–337.
15. Alves, A., Panis, Y., Pocard, M., Regimbeau, J. M., Valleur, P. Management of anastomotic leakage after nondiverted large bowel resection. J. Am. Coll. Surg., 1999; 189: 554–549.
16. Luna Perez, P., Rodriguez Ramirez, S., Gonzalez Macouzet, J., Rodriguez Coria, D. F. Treatment of anastomotic leakage following low anterior resection for rectal adenocarcinoma. Rev. Invest. Clin., 1999; 51: 23–29.
17. Pera, M., Delgado, S., Garcia-Valdecasas, J. C., Pera, M., Castells, A., Pique, J. M., Bombuy, E., Lacy, A. M. The management of leaking rectal anastomoses by minimally invasive techniques. Surg. Endosc., 2002; 16: 603–606.
18. Wolf, A. M., Henne-Bruns, D. Anastomoseninsuffizienz im Gastrointestinaltrakt: Diagnostik und Therapie. Chirurg, 2002; 73: 394–405; quiz 406–407.
19. Willis, S., Stumpf, M. Insuffizienzen nach Eingriffen am unteren Gastrointestinaltrakt. Chirurg, 2004; 75: 1071–1078.
20. Weidenhagen, R., Gruetzner, K. U., Wiecken, T., Spelsberg, F., Jauch, K. W. Endoscopic vacuum-assisted closure of anastomotic leakage following anterior resection of the rectum: a new method. Surg. Endosc., 2007; epub:.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2008 Issue 8
Most read in this issue
- Serious Complications Following Simple Appendectomy
- Laparoscopic Proctocolectomy with Ileal Pouch-Anal Anastomosis
- Reconstruction of Anal Sphincters Following Fecal Incontinence and Assessment of Functional Results
- Clostridium Difficile Colitis