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Endoscopy
DOI: 10.1055/a-2627-3149
Systematic review

Comparison of the treatment of endo-vacuum therapy with standard care for colorectal anastomotic leakage: a systematic review and meta-analysis

Heng Luo
1   Department of General Surgery, Nanchong Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China (Ringgold ID: RIN662481)
,
Zhenguo Gao
1   Department of General Surgery, Nanchong Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China (Ringgold ID: RIN662481)
,
Xiyan Lei
2   Clinical research group, Grade 2021 in Department of Clinical Medicine, North Sichuan Medical College, Nanchong, China (Ringgold ID: RIN74655)
,
Jian Zhou
1   Department of General Surgery, Nanchong Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China (Ringgold ID: RIN662481)
,
Zhenhong Wang
1   Department of General Surgery, Nanchong Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China (Ringgold ID: RIN662481)
,
Guobiao Chen
1   Department of General Surgery, Nanchong Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China (Ringgold ID: RIN662481)
,
Botao Qian
1   Department of General Surgery, Nanchong Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China (Ringgold ID: RIN662481)
,
Mi Tang
1   Department of General Surgery, Nanchong Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China (Ringgold ID: RIN662481)
,
Yunhong Tian 
3   Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College（University）, Nanchong, China
› Author Affiliations
Supported by: Key Clinical Specialty in Sichuan Province , Sichuan Provincial administration of Traditional Chinese Medicine , Soft Science Research Project of Science and Technology Department of Sichuan Province . [2023JDR0209],[2024MS611],[ZX-2428-1]
› Further Information
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Abstract: Aim: This systematic review and meta-analysis aimed to evaluate the effectiveness of Endo-Vacuum therapy (EVT) compared to standard care in managing colorectal anastomotic leakage, a serious complication following colorectal surgery. Materials and Methods: We conducted a literature search across PubMed, Embase, and the Cochrane Library for clinical studies published before October 2024. Studies compared outcomes of EVT and standard care, with reported on closure rates of anastomotic leakage, treatment duration, hospital stay duration, or postoperative complications. The pooled estimates of RR or mean differences were primarily derived using a fix-effects model,a random-effects model was employed when high heterogeneity was detected. Results: The analysis included six observational studies, involving a total of 273 patients. EVT was associated with a significantly higher closure rate compared to standard care (RR 1.18, 95% CI 1.03–1.35, P=0.02). Treatment duration was significantly shorter in the EVT group (mean difference -30.58 days, 95% CI -43.47 to -17.70,P＜0.00001), while hospital stay duration showed no significant difference between EVT and standard care (mean difference 1.73 days, 95% CI -4.23 to 7.69,P=0.57). No statistically significant difference was found in the rate of treatment-related complications between EVT and standard care (RR 1.17, 95% CI 0.52–2.80, p=0.71). Conclusion: This meta-analysis suggests that EVT has superior effectiveness in improving closure rates, as well as a shorter treatment duration compared to standard care for colorectal anastomotic leakage. However, this study is constrained by the lack of prospective data, the risk of selection bias and heterogeneity, requiring cautious interpretation of the findings.



Publication History

Received: 21 November 2024

Accepted after revision: 03 June 2025

Accepted Manuscript online:
03 June 2025

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