title: Promising results after endoscopic vacuum treatment of anastomotic leakage following resection of rectal cancer with ileostomy.
abstract: BACKGROUND
  In colorectal surgery, the most feared complication is anastomotic leakage (AL), which is associated with a high morbidity and mortality. In this study, we focus on treatment of perianastomotic abscess following AL after low anterior resection (LAR) of rectal cancer. In the literature, conservative irrigation regimes are reported to perdure for months and some even years and to be associated with a poor stoma closure rate. In the present paper, we evaluated endoscopic vacuum treatment of the perianastomotic abscess.
  
  
  METHODS
  Patients who had LAR due to rectal cancer with total mesorectal excision (TME) performed in Slagelse and Næstved Hospitals in the 2008-2012 (1st February) period were identified in the Danish Colorectal Cancer Group database. We included patients who had AL and who did not require emergency reoperation and were treated with endoscopic vacuum in the study period. Patients who initiated treatment more than one month after the leakage were excluded. All patients had primary ileostomy.
  
  
  RESULTS
  A total of 13 patients were included. All patients had successful closure of the perianastomotic abscess for a median of 18 (3-40) days in a median of eight (1-18) sessions. The median length of hospital stay was 25 (7-39) days. Mortality was zero, and the stoma closure rate was 12/13 (97%).
  
  
  CONCLUSIONS
  Our data support the positive findings previously reported by other studies. Endoscopic vacuum treatment seems to be a safe approach for selected patients in the treatment of perianastomotic abscess after LAR with TME of rectal cancer.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors: Department of Surgical Gastroenterology, Hvidovre Hospital, 2650 Hvidovre, Denmark. nikolajnerup@gmail.com
authors: Nikolaj
authors: N
authors: Nerup
authors: John Lykkegaard
authors: JL
authors: Johansen
authors: Ghalib Ali Abod
authors: GA
authors: Alkhefagie
authors: Pierre
authors: P
authors: Maina
authors: Kenneth Højsgaard
authors: KH
authors: Jensen
mesh_terms: D000038:Abscess / Q000209:etiology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak / Q000209:etiology / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007081:Ileostomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D014618:Vacuum