Use of sponge-assisted endoluminal vacuum therapy for the treatment of colorectal anastomotic leaks: expert panel consensus.
Journal
BJS open
ISSN: 2474-9842
Titre abrégé: BJS Open
Pays: England
ID NLM: 101722685
Informations de publication
Date de publication:
02 09 2022
02 09 2022
Historique:
received:
13
06
2022
revised:
17
08
2022
accepted:
25
08
2022
entrez:
21
10
2022
pubmed:
22
10
2022
medline:
25
10
2022
Statut:
ppublish
Résumé
Anastomotic leaks represent one of the most significant complications of colorectal surgery and are the primary cause of postoperative mortality and morbidity. Sponge-assisted endoluminal vacuum therapy (EVT) has emerged as a minimally invasive technique for the management of anastomotic leaks; however, there are questions regarding patient selection due to the heterogeneous nature of anastomotic leaks and the application of sponge-assisted EVT by surgeons. Seven colorectal surgical experts participated in a modified nominal group technique to establish consensus regarding key questions that arose from existing gaps in scientific evidence and the variability in clinical practice. After a bibliographic search to identify the available evidence and sequential meetings with participants, a series of recommendations and statements were formulated and agreed upon. Thirty-seven recommendations and statements on the optimal use of sponge-assisted EVT were elaborated on and unanimously agreed upon by the group of experts. The statements and recommendations answer 10 key questions about the indications, benefits, and definition of the success rate of sponge-assisted EVT for the management of anastomotic leaks. Although further research is needed to resolve clinical and technical issues associated with sponge-assisted EVT, the recommendations and statements produced from this project summarize critical aspects to consider when using sponge-assisted EVT and to assist those involved in the management of patients with colorectal anastomotic leaks.
Sections du résumé
BACKGROUND
Anastomotic leaks represent one of the most significant complications of colorectal surgery and are the primary cause of postoperative mortality and morbidity. Sponge-assisted endoluminal vacuum therapy (EVT) has emerged as a minimally invasive technique for the management of anastomotic leaks; however, there are questions regarding patient selection due to the heterogeneous nature of anastomotic leaks and the application of sponge-assisted EVT by surgeons.
METHOD
Seven colorectal surgical experts participated in a modified nominal group technique to establish consensus regarding key questions that arose from existing gaps in scientific evidence and the variability in clinical practice. After a bibliographic search to identify the available evidence and sequential meetings with participants, a series of recommendations and statements were formulated and agreed upon.
RESULTS
Thirty-seven recommendations and statements on the optimal use of sponge-assisted EVT were elaborated on and unanimously agreed upon by the group of experts. The statements and recommendations answer 10 key questions about the indications, benefits, and definition of the success rate of sponge-assisted EVT for the management of anastomotic leaks.
CONCLUSION
Although further research is needed to resolve clinical and technical issues associated with sponge-assisted EVT, the recommendations and statements produced from this project summarize critical aspects to consider when using sponge-assisted EVT and to assist those involved in the management of patients with colorectal anastomotic leaks.
Identifiants
pubmed: 36268752
pii: 6765232
doi: 10.1093/bjsopen/zrac123
pmc: PMC9585396
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.
Références
Surg Laparosc Endosc Percutan Tech. 2015 Dec;25(6):505-8
pubmed: 26551234
Colorectal Dis. 2011 Nov;13 Suppl 7:18-22
pubmed: 22098512
Surg Endosc. 2018 Jan;32(1):315-327
pubmed: 28664443
Gastroenterology. 2018 May;154(7):1938-1946.e1
pubmed: 29454791
Therap Adv Gastroenterol. 2019 Sep 22;12:1756284819877606
pubmed: 31579099
Surg Endosc. 2009 Jun;23(6):1379-83
pubmed: 19037698
Colorectal Dis. 2020 Mar;22(3):243-253
pubmed: 31274227
World J Surg. 2020 Apr;44(4):1277-1282
pubmed: 31965274
Endosc Int Open. 2021 Aug 16;9(9):E1342-E1349
pubmed: 34466357
Colorectal Dis. 2015 May;17(5):426-32
pubmed: 25512241
BJS Open. 2018 Oct 15;3(1):106-111
pubmed: 30734021
Surg Technol Int. 2017 Jan 10;30:125-130
pubmed: 28072899
Colorectal Dis. 2013 Apr;15(4):e190-8
pubmed: 23331871
Colorectal Dis. 2017 Jan;19(1):O1-O12
pubmed: 27671222
BJS Open. 2018 Dec 26;3(2):153-160
pubmed: 30957061
Tech Coloproctol. 2019 Jun;23(6):551-557
pubmed: 31338710
Tech Coloproctol. 2020 Jul;24(7):685-694
pubmed: 32377984
Wideochir Inne Tech Maloinwazyjne. 2020 Dec;15(4):560-566
pubmed: 33294070
Surg Endosc. 2008 Aug;22(8):1818-25
pubmed: 18095024
Surg Endosc. 2019 Apr;33(4):1049-1065
pubmed: 30675662
J Crohns Colitis. 2019 Dec 10;13(12):1537-1545
pubmed: 31054256
Dig Liver Dis. 2015 Jun;47(6):465-9
pubmed: 25769505
J Gastrointest Surg. 2016 Feb;20(2):328-34
pubmed: 26597270
Dis Colon Rectum. 2020 Mar;63(3):371-380
pubmed: 31842165
Int J Clin Pharm. 2016 Jun;38(3):655-62
pubmed: 26846316
Dig Liver Dis. 2015 Apr;47(4):342-5
pubmed: 25563812
Rozhl Chir. 2008 Aug;87(8):397-402
pubmed: 18988480
Updates Surg. 2020 Sep;72(3):781-792
pubmed: 32613380