title: Long-term efficacy of endoscopic vacuum therapy for the treatment of colorectal anastomotic leaks.
abstract: BACKGROUND
  Anastomotic leaks are a severe complication after colorectal surgery. We aimed to evaluate the long-term efficacy of endoscopic vacuum therapy for their treatment.
  
  
  METHODS
  Retrospective review of a series of post-surgical colorectal leaks treated with endoscopic vacuum therapy, with minimum follow-up of 1 year. Generalized peritonitis or haemodynamic instability was considered contraindication to endoscopic treatment.
  
  
  RESULTS
  Endoscopic vacuum therapy was applied in 14 patients with colorectal leak, in 2 cases complicated by recto-vaginal fistula. Overall success rate was 79%, favoured by early beginning of treatment (90%) and presence of a stoma (100%) and no preoperative radiotherapy (86%). Median duration of treatment was 12.5 sessions (range 4-40). Median time for complete healing was 40.5 days (range 8-114), for a median cost of treatment of 3125 Euros. No complication related to endoscopic vacuum therapy was observed. Further surgery was required in 3 cases.
  
  
  CONCLUSIONS
  Endoscopic vacuum therapy is a safe treatment for post-surgical leaks, with high success rates.
authors.affiliation: Department of Surgical Sciences, University of Torino, Italy. Electronic address: alberto.arezzo@unito.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Arezzo
authors.affiliation: Department of Surgical Sciences, University of Torino, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Verra
authors.affiliation: Department of Surgical Sciences, University of Torino, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Passera
authors.affiliation: Department of Surgical Sciences, University of Torino, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bullano
authors.affiliation: Department of Surgical Sciences, University of Torino, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Rapetti
authors.affiliation: Department of Surgical Sciences, University of Torino, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Morino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak / Q000628:therapy*; D003106:Colon / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D003107:Colorectal Surgery / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014618:Vacuum
keywords: Anastomotic leak; Colorectal surgery; Endoscopic vacuum; Postoperative complications