title: Treatment of anastomotic leakage after rectal resection with transrectal vacuum-assisted drainage (VAC). A method for rapid control of pelvic sepsis and healing.
abstract: OBJECTIVE
  Anastomotic leakage after rectal resection is associated with high morbidity and mortality. Patients without peritonitis can be treated conservatively by transrectal rinsing and drainage. However, healing is often very slow, and formation of abundant scar tissue resulting in a poor functional result is not uncommon. Vacuum-assisted closure (VAC) has been shown to accelerate wound healing by increasing local blood flow, reducing bacterial load and stimulating growth of granulation tissue. In this paper, we describe VAC as a method for treating anastomotic leakage after rectal resection.
  
  
  METHODS
  Four patients with anastomotic leakage after rectal resections were treated with VAC.
  
  
  RESULTS
  Healing time for these patients was median 51 days (43-195). The control group consisted of patients treated conservatively in the previous 5-year period. Ten patients were identified with median healing time 336 days (52-1434).
  
  
  CONCLUSIONS
  VAC treatment may possibly shorten healing time of anastomotic leakages after rectal resection. However, the presented results are preliminary, with only few patients included, and obviously, larger, randomized, clinical trials are needed to confirm these results and establish the indication for VAC treatment in clinical practice. We believe VAC therapy is a promising treatment of anastomotic leakage after rectal resection.
authors.affiliation: Department of Surgical Gastroenterology, Hvidovre University Hospital, Kettegaards Allé, 2650, Hvidovre, Copenhagen, Denmark. rikke.frederik@dadlnet.dk
authors.forename: Carl Frederik
authors.initials: CF
authors.lastname: Nagell
authors.forename: Kathrine
authors.initials: K
authors.lastname: Holte
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D016022:Case-Control Studies; D004322:Drainage / Q000379:methods*; D006801:Humans; D010388:Pelvis / Q000473:pathology*; D012007:Rectum / Q000601:surgery*; D018805:Sepsis / Q000517:prevention & control*; D013997:Time Factors; D014618:Vacuum; D014945:Wound Healing