Journal of Gastrointestinal & Digestive System
Open Access

Abstract

Aim: Anastomotic leakage is one of the most feared complications of colorectal surgery. It causes considerable morbidity and mortality, and contributes to local tumor recurrence.The risk also varies with the site of the anastomosis with those placed less than 5 cm from the anal verge being particularly vulnerable. This study aimed to determinate the effectiveness and direct medical costs of early surgical closure of the anastomotic defect after short course of Endosponge®. Method: Between January 2004 and December 2012, 12 patients with anastomotic leakage following low anterior resection and neoadjuvantradiochemotherapywere treated with transrectalEndosponge.They were prospectively evaluated. Results: Stapled straight end to end colorectal anastomoses were performed in all patients between 3 and 7 cm above the anal verge, a protective ileostomy was performed in every patients.The diagnosis of anastomotic leakage was performed after a median interval of 15 days (range 7-22) the median size of the cavity was 81x46 mm.The median duration of therapy was 35 days (range 16-51), with 8-15 sponge exchanges for patient. Median healing time was 59 days (range 32-65). No intraoperative complications were recorded, 5 cases of mild anal pain successfully treated medically. Conclusion: According the European experience and our results, the Endosponge seems an effective minimally invasive procedure to treat extraperitoneal anastomotic leakage without reintervention reducing morbidity and mortality among patients.

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