Modified Endoluminal Vacuum Therapy for the Treatment of Colorectal Fistula: Experience from a Gastroenterology Unit in a High-Complexity Institution
DOI:
https://doi.org/10.22516/25007440.1278Keywords:
Endoscopy, gastrointestinal fistula, surgical anastomosisAbstract
Endoluminal vacuum therapy (Endo-Vac) may be a promising option for the endoscopic management of challenging gastrointestinal fistulas or perforations. However, one of the barriers to its implementation is the high cost associated with conventional systems. Consequently, modified techniques using readily available and lower-cost materials have been developed. This report describes the successful endoscopic closure of a colorectal anastomotic fistula using a modified Endo-Vac technique. Despite using materials different from those in conventional systems, this approach may represent an effective and lower-cost alternative for managing anastomotic complications, facilitating its implementation in settings with limited resources.
Downloads
References
Lee WS, Yun SH, Roh YN, Yun HR, Lee WY, Cho YB, et al. Risk factors and clinical outcome for anastomotic leakage after total mesorectal excision for rectal cancer. World J Surg. 2008;32(6):1124-9. https://doi.org/10.1007/s00268-007-9451-2
Matthiessen P, Hallböök O, Andersson M, Rutegård J, Sjödahl R. Risk factors for anastomotic leakage after anterior resection of the rectum. Colorectal Dis. 2004;6(6):462-9. https://doi.org/10.1111/j.1463-1318.2004.00657.x
Pinilla RE, Aramendiz MC, Williams E, Caycedo-Marulanda A. Endo-VAC customization for sinus/anastomotic-leaks/dehiscence after colorectal anastomosis. Tech Coloproctol. 2020;24(10):1095-1096. Tech Coloproctol. 2021;25(3):355. https://doi.org/10.1007/s10151-020-02326-2
de Moura DTH, de Moura BFBH, Manfredi MA, Hathorn KE, Bazarbashi AN, Ribeiro IB, et al. Role of endoscopic vacuum therapy in the management of gastrointestinal transmural defects. World J Gastrointest Endosc. 2019;11(5):329-344. https://doi.org/10.4253/wjge.v11.i5.329
Loske G, Rucktaeschel F, Schorsch T, Moenkemueller K, Mueller CT. Endoscopic negative pressure therapy (ENPT) for duodenal leakage - novel repair technique using open-pore film (OFD) and polyurethane-foam drainages (OPD). Endosc Int Open. 2019;7(11): E1424-E1431. https://doi.org/10.1055/a-0972-9660
Ramírez Barranco R, Cañadas Garrido RA, Cáceres Escobar D. Terapia de vacío endoluminal (Endo-Vac) en el manejo de la fístula de anastomosis esofagogástrica. Rev Colomb Gastroenterol. 2022;37(1):83-9. https://doi.org/10.22516/25007440.710
Mencio MA, Ontiveros E, Burdick JS, Leeds SG. Use of a novel technique to manage gastrointestinal leaks with endoluminal negative pressure: a single institution experience. Surg Endosc. 2018;32(7):3349-3356. https://doi.org/10.1007/s00464-018-6055-x
Saavedra JEM, Carrillo CAT, Valbuena GLM. Outpatient closure in a late colo-cutaneous postoperative anastomotic leak managed with EVAC in Bucaramanga, Colombia. Case report. Int J Surg Case Rep. 2022;100:107737. https://doi.org/10.1016/j.ijscr.2022.107737
Ooi G, Burton P, Packiyanathan A, Loh D, Chen R, Shaw K, et al. Indications and efficacy of endoscopic vacuum-assisted closure therapy for upper gastrointestinal perforations. ANZ J Surg. 2018;88(4):E257-E263. https://doi.org/10.1111/ans.13837
Banco Mundial. América Latina y el Caribe: panorama general. Banco Mundial; 2023 [consultado el 21 de agosto de 2023]. Disponible en: https://www.bancomundial.org/es/region/lac/overview
Kiko I, Nehring D, Ma T. Creation of a Custom Endoluminal Vacuum-Assisted Device for Salvage of Ileal Pouch-Anal Anastomotic Leak. Cureus. 2023;15(11):e49754. https://doi.org/10.7759/cureus.49754
de Moura DTH, Hirsch BS, McCarty TR, Lera Dos Santos ME, Guedes HG, Gomes GF, et al. Homemade endoscopic vacuum therapy device for the management of transmural gastrointestinal defects. Dig Endosc. 2023;35(6):745-756. https://doi.org/10.1111/den.14518
de Moura DTH, Hirsch BS, Do Monte Junior ES, McCarty TR, de Medeiros FS, Thompson CC, et al. Cost-effective modified endoscopic vacuum therapy for the treatment of gastrointestinal transmural defects: step-by-step process of manufacturing and its advantages. VideoGIE. 2021;6(12):523-528. https://doi.org/10.1016/j.vgie.2021.08.002
de Moura DTH, do Monte Junior ES, Hathorn KE, de Medeiros FS, Thompson CC, de Moura EGH. Modified endoscopic vacuum therapy in the management of a duodenal transmural defect. Endoscopy. 2021;53(1):E17-E18. https://doi.org/10.1055/a-1173-7282
de Moura DTH, do Monte Junior ES, Hathorn KE, Ribeiro IB, de Medeiros FS, Thompson CC, et al. The use of novel modified endoscopic vacuum therapies in the management of a transmural rectal wall defect. Endoscopy. 2021;53(1):E27-E28. https://doi.org/10.1055/a-1173-7727
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Revista colombiana de Gastroenterología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
Los autores/as ceden sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación en esta revista.
Los contenidos están protegidos bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
