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<p>Anastomotic insufficiency in the lower gastrointestinal (GI) tract is a&#xa0;dangerous complication of colorectal surgery. In addition to conventional surgery with a&#xa0;protective stoma, endoluminal treatment methods are becoming increasingly more established. Small defects can be treated with OTSC® clips, while vacuum therapy is used for larger defects. Fully covered self-expanding metal stents (fcSEMS) enable defect bridging and covering, continuity of enteral feeding due to the prevention of enteral obstruction and easy removal but have a&#xa0;high risk of migration and lack a&#xa0;drainage function. Endoscopic vacuum therapy (EVT), for example using Endo-SPONGE®, achieves high healing rates but requires frequent sponge changes and a&#xa0;protective stoma can usually not be avoided. The innovative procedure of the VacStent combines the advantages of EVT and SEMS for the first time. The Colovac+ system could only offer an alternative to the prophylactic ileostomy. The VacStent combines stent and vacuum sponge for efficient defect healing with low risk of migration and very good drainage function of the sponge cylinder. Current studies show promising results but more research is needed.</p>

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Endoluminale Therapie der Anastomoseninsuffizienz im unteren gastrointestinalen Trakt

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月25日

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  • Alexander Yohannes,
  • Markus M. Heiss

摘要

Anastomotic insufficiency in the lower gastrointestinal (GI) tract is a dangerous complication of colorectal surgery. In addition to conventional surgery with a protective stoma, endoluminal treatment methods are becoming increasingly more established. Small defects can be treated with OTSC® clips, while vacuum therapy is used for larger defects. Fully covered self-expanding metal stents (fcSEMS) enable defect bridging and covering, continuity of enteral feeding due to the prevention of enteral obstruction and easy removal but have a high risk of migration and lack a drainage function. Endoscopic vacuum therapy (EVT), for example using Endo-SPONGE®, achieves high healing rates but requires frequent sponge changes and a protective stoma can usually not be avoided. The innovative procedure of the VacStent combines the advantages of EVT and SEMS for the first time. The Colovac+ system could only offer an alternative to the prophylactic ileostomy. The VacStent combines stent and vacuum sponge for efficient defect healing with low risk of migration and very good drainage function of the sponge cylinder. Current studies show promising results but more research is needed.