Endo-SPONGE® Clinical evidence

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10 years of experience treating anastomotic leakages with Endo-SPONGE® have obtained good results supported by clinical data.

Clinical Evidence Folder

The endoluminal vacuum therapy (EVT) for rectal anastomotic leakage treatment was firstly described by Weidenhagen in 2008. Since then various retrospective and prospective cohort studies have been published using Endo-SPONGE® to treat lower Gastrointestinal (GI) defects.
Up to present 40 publications have showed their outcomes and conclusions. These scientific investigations is summarised in the present clinical evidence folder.

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Clinical Evidence Folder Endo-SPONGE® Endoluminal vacuum therapy for the treatment of rectal anastomotic leakage
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Outcomes at a glance

Superior outcomes

  • Short treatment time compared to conventional therapies [2], [3]
  • Trend to reduce number of reintervention [4]

Improve patient quality of life

  • Ambulatory treatment possible [5], [6], [7]
  • Good patient acceptance [6], [7], [8]

Results summary

The latest series of patients using endoluminal vacuum therapy for the treatment of anastomotic leakage, after rectal resection, shows 31 days per patient as the average time required for treatment. The average of total number of sponges used per patients are 8 sponges.

The combined successful average rate meaning total healing of the leakage cavity, was 85% of the cases [12].

Literature n Duration of therapy (days) Number of sponges Success
Nagell et al. Int J Colorectal Dis [2] 4 51 NA  100% 
Weidenhagen et al. Surg Endosc [5]  29  34  11  97% 
Glitsch et al. Endoscopy 17  21  94% 
Van Koperen et al. Surg Endosc 16  40  13  56% 
Riss et al. Colorectal Dis [6] 21  67% 
Nerup et al. Dan Med J [11]  13  18  100% 
Arezzo et al. Dig Liv Dis [7]  14  41  13  79% 
Kuchn et al. 2015 (in this paper) 20  23  90% 
  122  31 85% 

The different success rate on the Van Koperen et al. series of patients can be explained by the fact that the authors also included a group of patients treated with Endo-SPONGE® after 6 week of leakage evolution, which reduces the total success rate to 56%. Without this group the successful rate would be 75% and the total average successful rate would be 88%.

All references at a glance

Num. Refs Link
[1] McDermott FD, Heeney A, Kelly ME, Steele RJ, Carlson GL, Winder DC.
Systematic review of perioperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks.
Br J Surg. 2015 Apr;102(5):462-79.Willis S, Stumpf M. Chirurg 2004, 75:1071-78.
more on Pubmed
[2] Nagell CF, Holte K.
Treatment of anastomotic leakage after rectal resection with transrectalvacuum-assisted drainage (VAC). A method for rapid control of pelvic sepsis and healing.
Int J Colorectal Dis. 2006 Oct;21(7):657-60.
more on Pubmed
[3] Mees ST, Palmes D, Mennigen R, Senninger N, Haier J, Bruewer M.
Endo-vacuum assisted closure treatment for rectal anastomotic insufficiency.
Diseases Colon Rectum. 2008 Apr;51(4):404-10.
more on Pubmed
[4] Weidenhagen R, Gruetzner KU, Wiecken T, Spelsberg F, Jauch KW.
Endoluminal vacuum therapy for the treatment of anastomotic leakage after anterior rectal resection.
Rozhl Chir. 2008 Aug;87(8):397-402.
more on Pubmed
[5] Weidenhagen R, Gruetzner KU, Wiecken T, Spelsberg F, Jauch KW.
Endoscopic vacuum-assisted closure of anatomotic leakage following anterior resection of the rectum: a new method.
Surg Endosc. 2008 Aug;22(8):1818-25.
more on Pubmed
[6] Riss S, Stift A, Meier M, Haiden E, Grünberger T, Bergmann M.
Endo-SPONGE® assisted treatment of anatomotic leakage following colorectal surgery.
Colorectal Dis. 2010 Jul;12 (7 Online):e104-8.
more on Pubmed
[7] Arezzo A, Verra M, Passera R, Bullano A, Rapetti L, Morino M.
Long-term efficacy of endoscopic vacuum therapy for the treatment of colorectal anastomotic leaks.
Dig Liver Dis. 2015 Apr;47(4):342-5.
more on Pubmed
[8] Strangio G, Zullo A, Ferrara EC, Anderloni A, Carlino A, Jovani M, Ciscato C, Hassan C, Repici A.
Endo-SPONGE® therapy for management of anastomotic leakages after colorectal surgery: A case series and review of the literature.
Dig Liver Dis. 2015 Jun;47(6):465-9.
more on Pubmed
[9] Schintler MV.
Negative pressure therapy: theory and practice.
Diabetes Metab Res Rev. 2012 Feb;28 Suppl 1:72-7.
more on Pubmed
[10] Tricco AC, Antony J, Vafaei A, Khan PA, Harrington A, Cogo E, Wilson C, Perrier P, Hui W, Starus SE.
Seeking effective interventions to treat complex wounds: an overview of systematic reviews.
BMC Med. 2015 Apr;22;13:89.
more on Pubmed
[11] Nerup N, Johansen JL, Alkhefagie GA, Maina P, Jensen KH.
Promising results after endoscopic vacuum treatment of anastomotic leakage following resection of rectal cancer with ileostomy.
Dan Med J. 2013 Apr;60(4):A4604.
more on Pubmed
[12] Kuehn F, Janisch F, Schwandner F, Alsfasser G, Schiffnann L, Gock M, Klar E.
Endoscopic Vacuum Therapy in Colorectal Surgery.
J Gastrointest Surg. 2016 Feb;20(2):328-34.
more on Pubmed
[13] Willis S, Stumpf M.
Leakages after surgery of the lower gastrointestinal tract
Chirurg 2004, 75:1071-78.
more on Pubmed
[14] Frasson M, Flor-Lorente B, Ramos Rodrıguez JL et al., ANACO study Group.
Risk factors for anastomotic leak after colon resection for cancer: multivariate analysis and nomogram from a multicentric, prospective, national study with 3193 patients.
Ann Surg 2015; 262: 321–30.                                      
more on Pubmed
[15] Argenta LC, Morykwas MJ (1997)
Vacuum-assisted closure: a new method for wound control and treatment: clinical experience.
Ann Plast Surg 38:563–576
more on Pubmed
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Any questions about the colorectal leakage treatment with Endo-SPONGE®?
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08191 Rubí (Barcelona)
Spain