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Recurrent abscess after primary successful endo-sponge treatment of anastomotic leakage following rectal surgery

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Author(s): Stefan Riss, Anton Stift, Caroline Kienbacher, Bernhard Dauser, Ingrid Haunold, Stefan Kriwanek, Wolfgang Radlsboek, Michael Bergmann

Journal: World Journal of Gastroenterology
ISSN 1007-9327

Volume: 16;
Issue: 36;
Start page: 4570;
Date: 2010;
Original page

Keywords: Rectal surgery | Anastomotic leakage | Endo-sponge | Endo-vacuum treatment

ABSTRACT
AIM: To assess long-term efficacy of initially successful endo-sponge assisted therapy.METHODS: Between 2006 and 2009, consecutive patients who had undergone primary successful endo-sponge treatment of anastomotic leakage following rectal cancer surgery were enrolled in the study. Patients were recruited from 6 surgical departments in Vienna. Clinical and oncologic outcomes were assessed through routine endoscopic and radiologic follow-up examination.RESULTS: Twenty patients (7 female, 13 male) were included. The indications for endo-sponge treatment were anastomotic leakage (n = 17) and insufficiency of a rectal stump after Hartmann’s procedure (n = 3). All patients were primarily operated for rectal cancer. The overall mortality rate was 25%. The median follow-up duration was 17 mo (range 1.5-29.8 mo). Five patients (25%) developed a recurrent abscess. Median time between last day of endo-sponge therapy and occurrence of recurrent abscess was 255 d (range 21-733 d). One of these patients was treated by computed tomography-guided drainage and in 3 patients Hartmann’s procedure had to be performed. Two patients (10%) developed a local tumor recurrence and subsequently died.CONCLUSION: Despite successful primary outcome, patients who receive endo-sponge therapy should be closely monitored in the first 2 years, since recurrence might occur.
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