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Assessment of the efficacy of Handmade Vacuum-Assisted Sponge Drain for Treatment of Anastomotic leakage after Low Anterior Rectal Resection

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Abstract

Anastomotic leakage is one of the major complications of colorectal surgery, which might lead to reoperation, increased hospital stays, further intervention and mortality. Vacuum-assisted closure by devices such as Endo-SPONGE® produced by (B-Braun Medical B.V.) is currently being used to treat leakage and fistula. In this study, we aimed to assess the handmade vacuum-assisted sponge drain for anastomotic leakage following low anterior resection. This prospective study included 22 patients who had undergone sponge drain placement to treat anastomotic leakage. All patients had anastomotic leaks or defects after left anterior rectal resection (LAR) without ileostomy. They were treated with neo-adjuvant chemotherapy before the surgery and then subjected to rigid recto-sigmoidoscopy for 30 days following the operation. Any sign of leakage, such as perianal and pelvic pain, was immediately identified and followed up with a CT scan and another recto-sigmoidoscopy. Twenty-two patients were enrolled in this study, 12 men (54.5%) and 10 women (47.4%). All patients had received neo-adjuvant chemotherapy with an average follow-up of 22.30 ± 3.81. 75% of patients (15 cases) were successfully treated, and 17 patients (85%) underwent successful ostomy closure. Treatment failed in 5 patients (25%), including three men and two women. This study shows that handmade vacuum-assisted sponge drain is a cost-effective method of anastomotic leakage management with efficacy similar to that of Endo-SPONGE®.

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Acknowledgements

We would like to express our gratitude for the contributions of the colorectal surgery ward at Imam Khomeini Hospital, Tehran University of Medical Sciences.

Funding

This study was self-funded by its authors and received no funding from any government/non-governmental organization.

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Authors and Affiliations

  1. Colorectal Research Center, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

    Amir Keshvari, Leila mollamohammadi, Mohammad Reza Keramati, Behnam Behboudi, Mohammad Sadegh Fazeli, Alireza Kazemeini, Amirhossein Naseri & Seyed-Mohsen Ahmadi-Tafti

  2. Division of Colorectal Surgery, Department of Surgery, Tehran University of Medical Sciences, Tehran, 1419733141, Iran

    Amir Keshvari, Leila mollamohammadi, Mohammad Reza Keramati, Behnam Behboudi, Mohammad Sadegh Fazeli, Alireza Kazemeini, Amirhossein Naseri & Seyed-Mohsen Ahmadi-Tafti

  3. Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Research Institute, Tehran University of Medical Sciences, Tehran, Iran

    Elnaz Shahmohammadi, Laleh Foroutani, Aryan Ayati, Amirhossein Tayebi & Alireza Hadizadeh

  4. Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran

    Zahra Sajjadian

Authors
  1. Amir Keshvari
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  2. Leila mollamohammadi
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  3. Mohammad Reza Keramati
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  4. Behnam Behboudi
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  5. Mohammad Sadegh Fazeli
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  7. Amirhossein Naseri
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  8. Elnaz Shahmohammadi
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  14. Seyed-Mohsen Ahmadi-Tafti
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Contributions

AK conceived and designed the investigation conducted surgery and participated in data gathering and manuscript composure. LM participated in data gathering and manuscript composure. MK conceived and designed the investigation and participated in data gathering and manuscript composure. BB participated in surgical intervention, coordinated tasks and participated in drafting and revising the manuscript. MSF participated in surgical intervention, coordinated tasks and participated in drafting. AK participated in surgical intervention, coordinated tasks and participated in drafting. AN performed surgical intervention. ES participated in manuscript drafting. LF participated in manuscript drafting and figure creation. ZS participated in manuscript drafting. AT participated in data gathering. AA participated in data gathering. AH conceived and designed the study. Participated in data gathering, manuscript drafting ad revision. SMA conceived and designed the study conducted surgeries and also contributed to patient follow-up.

Corresponding authors

Correspondence to Alireza Hadizadeh or Seyed-Mohsen Ahmadi-Tafti.

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The authors declare no conflicts of interest.

Ethics statement

This study was submitted to and ethically approved by the Research Deputy and the Ethics Committee of the Tehran University of Medical Sciences (Reference number: IR.TUMS.THC.REC.1400.070) and was carried out per the ethical standards outlined in the 1964 Declaration of Helsinki and all subsequent revisions. All participants signed a written informed consent form.

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Keshvari, A., mollamohammadi, L., Keramati, M. et al. Assessment of the efficacy of Handmade Vacuum-Assisted Sponge Drain for Treatment of Anastomotic leakage after Low Anterior Rectal Resection. Updates Surg 75, 847–854 (2023). https://doi.org/10.1007/s13304-023-01518-3

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