Endoscopy 2020; 52(S 01): S103-S104
DOI: 10.1055/s-0040-1704318
ESGE Days 2020 oral presentations
Friday, April 24, 2020 14:30 – 16:30 Keeping the lumen Liffey Meeting Room 2
© Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC TREATMENT OF RECTAL ANASTOMOTIC DEHISCENCES - SINGLE-CENTRE EXPERIENCE

J Cortez-Pinto
1   Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Gastroenterology, Lisboa, Portugal
,
I Rosa
1   Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Gastroenterology, Lisboa, Portugal
,
SM Ferro
2   Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Gastroenterology, Buraca - Amadora, Portugal
,
I Marques
3   Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Gastroenterology, Lisbon, Portugal
,
J Moleiro
3   Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Gastroenterology, Lisbon, Portugal
,
R Barroca
4   Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Surgery, Lisboa, Portugal
,
M Limbert
4   Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Surgery, Lisboa, Portugal
,
J Maciel
4   Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Surgery, Lisboa, Portugal
,
L d´Orey
4   Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Surgery, Lisboa, Portugal
,
AD Pereira
3   Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Gastroenterology, Lisbon, Portugal
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 
 

    Aims Advances in rectal carcinoma surgery have dramatically increased the number of sphincter-saving procedures. However, an increase in anastomotic dehiscences (AD) was concomitantly observed.

    Endoscopic treatment of AD in the rectum, through clips or endoluminal vacuum therapy (Endo-SPONGE B-Braun Medical), appears to be effective in selected cases, sparing patients from definitive colostomies.

    Aims To evaluate the safety and efficacy of endoscopic treatments in rectal AD closure.

    Methods Retrospective single-centre study. All patients with rectal AD (08/2015 - 07/2019) submitted to endoscopic treatment were evaluated.

    Clinical data, endoscopic treatments used in AD, and their complications and efficacy were analysed.

    Results 10 patients with rectal AD were included [5 males, mean age at diagnosis: 56,6 years (36-72)]. Cancers were mostly in the middle rectum (5/10). All patients had received neoadjuvant therapy followed by anterior resection of the rectum with mechanical anastomosis and protective colostomy.

    Median time between AD diagnosis and endoscopic treatment was 9,5weeks (1-58) and between surgery and endoscopic treatment was 25,5weeks (3-165).

    The following endoscopic methods were used: Endo-SPONGE (5/10), EndoSPONGE + OTSC (1/10), Endo-SPONGE + TTS Clips (1/10) and TTS Clips (3/10), depending on the size of the dehiscence.

    Patients submitted to Endo-SPONGE required a median of 10 (4-17) sessions [1 sponge per session (5/7); 2 sponges per session (2/7)]. There was a major complication in a case with complete dehiscence (Endo-SPONGE migration to the peritoneal cavity requiring surgery for removal) and therefore definitive colostomy was performed. 2 patients received adjuvant chemotherapy while in treatment.

    Endoscopic treatment was successful in 9 patients, allowing bowel reconstruction (already performed in 5, scheduled in 4).

    Conclusions Endoscopic treatment of rectal AD is safe and effective and should be tried in selected cases, since it may significantly improve the quality of life of these patients.


    #