Annals of Coloproctology

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Original Article

Malignant disease, Rectal cancer, Functional outcomes

Introduction of a handmade vacuum-assisted sponge drain for the treatment of anastomotic leakage after low anterior rectal resection: Amir Keshvari, Abolfazl Badripour, Mohammad Reza Keramati, Alireza Kazemeini, Behnam Behboudi, Mohammad Sadegh Fazeli, Ehsan Rahimpour, Parisa Ghaffari, Seyed Mohsen Ahmadi Tafti; Ann Coloproctol. 2022;38(3):230-234. Published online June 10, 2021; DOI: https://doi.org/10.3393/ac.2021.00059.0008

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Purpose
Anastomotic leakage, a known major postoperative complication, potentially leads to readmission, reoperation, and increased mortality rates in patients, such as rectal cancer patients following a low anterior resection (LAR). Currently, vacuum-assisted closure, as featured by B-Braun (B-Braun Medical B.V.), is already being used for the treatment of gastrointestinal leakages and fistulas. The main aim of this study was to introduce a novel method for creating a vacuum-assisted drain for the treatment of anastomotic leakage after LAR.
Methods
All 10 patients, who underwent LAR surgery from 2018 to 2019, were diagnosed with anastomotic leakage and had received neoadjuvant chemotherapy prior to surgery. Therefore, patients were treated with a handmade vacuum-assisted drain and were revisited every 5 to 7 days for further evaluations and drain replacement until leakage resolution. Physical features of cavity, time of diagnose, and duration of treatment were analyzed correspondingly. The handmade vacuum-assisted sponge drain was prepared for each patient in each session of follow-up.
Results
Eight out of 10 patients experienced complete closure of the defect. The mean delay time from the day of operation to the diagnosis of anastomotic leakage was 61.0±80.4 days while the mean time for leakage closure was 117.6±68.3 days. Eventually, 7 cases underwent ileostomy reversal with no complications during a 3-month follow-up.
Conclusion
In this study, we evaluated the healing process of anastomotic leakage after the usage of a handmade vacuum-assisted sponge drain in a case series method. In our trial, we provided an innovative cost-benefit method easily applicable in the operating room.

Citations

Citations to this article as recorded by

Ghost Ileostomy Versus Protective Ileostomy in Rectal Cancer Followed by Low Anterior Resection: A Randomized Feasibility Trial
Seyed Mostafa Meshkati Yazd, Mohammad Reza Keramati, Marzieh Ghanbari Ghalerudkhani, Reza Shahriarirad, Amir Parsa, Amir Keshvari
Health Science Reports.2025;[Epub] CrossRef
Optimal Indocyanine Green Dosage for Repetitive Angiography for Laparoscopic Colorectal Surgery
Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang, Kwang-Ryul Baek
Medicina.2024; 60(12): 1966. CrossRef
Assessment of the efficacy of Handmade Vacuum-Assisted Sponge Drain for Treatment of Anastomotic leakage after Low Anterior Rectal Resection
Amir Keshvari, Leila mollamohammadi, Mohammad Reza Keramati, Behnam Behboudi, Mohammad Sadegh Fazeli, Alireza Kazemeini, Amirhossein Naseri, Elnaz Shahmohammadi, Laleh Foroutani, Aryan Ayati, Amirhossein Tayebi, Zahra Sajjadian, Alireza Hadizadeh, Seyed-M
Updates in Surgery.2023; 75(4): 847. CrossRef
Endoscopic vacuum therapy and early surgical closure after pelvic anastomotic leak: meta-analysis of bowel continuity rates
F. Borja de Lacy, Kevin Talboom, Sapho X. Roodbeen, Robin Blok, Anna Curell, Pieter J. Tanis, Wilhelmus A. Bemelman, Roel Hompes
British Journal of Surgery.2022;[Epub] CrossRef
Outpatient closure in a late colo-cutaneous postoperative anastomotic leak managed with EVAC in Bucaramanga, Colombia. Case report.
Jairo Enrique Mendoza Saavedra, Cesar Andrés Torres Carrillo, Gloria Liliana Mendoza Valbuena
International Journal of Surgery Case Reports.2022; 100: 107737. CrossRef
Neoadjuvant chemoradiotherapy determines the prognostic impact of anastomotic leakage in advanced rectal cancer
Bo Young Oh, Yoon Ah Park, Jung Wook Huh, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee
Annals of Surgical Treatment and Research.2022; 103(4): 235. CrossRef

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