AI Article Synopsis
- Neoadjuvant radiochemotherapy (nRCT) does not negatively impact the success rates of endoscopic vacuum therapy (EVT) for anastomotic leakage in rectal cancer, with more than 90% success overall.
- Despite high success rates, patients who underwent nRCT required a significantly longer duration of EVT (31.1 days vs. 15.9 days).
- The study highlights that while mortality and long-term outcomes are similar regardless of neoadjuvant treatment, nRCT leads to an increased number of sponge applications during the EVT process.
Article Abstract
Background: Neoadjuvant radiochemotherapy (nRCT) is an important component in the treatment of advanced rectal cancer. Endoscopic vacuum therapy (EVT) has become the treatment of choice for anastomotic leakage after rectal resection in many institutions in Germany. Published case series report on average success and stoma reversal rates of more than 80%. However, so far, there is no distinct report on the potential influence of nRCT on EVT.
Methods: A total of 11 patients treated with EVT for anastomotic leakage after nRCT and rectal resection were retrospectively compared with a cohort of eight patients with rectal anastomotic leakage without neoadjuvant treatment. Primary endpoints were death, treatment success, and long-term preservation of intestinal continuity. Secondary endpoint was the duration of treatment. Statistical analysis was performed using Statistical Package for Social Science (SPSS) version 23.0.
Results: There was no difference in mortality (0%), success rate (90.9% 100%, = 0.381), or long-term preservation of continuity (63.6% 62.5%, = 0.960). After nRCT, patients showed a significant longer duration of EVT (31.1 days 15.9 days, = 0.040) which was associated with a significantly higher number of sponge applications (9.6 5.0, = 0.042).
Conclusions: In our analysis, EVT showed success in over 90% of patients with anastomotic leakage after rectal resection for colorectal cancer, regardless of neoadjuvant treatment. However, in case of anastomotic leakage, nRCT seems to be associated with the need for a significant longer duration of EVT.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6759710 | PMC |
| http://dx.doi.org/10.1177/1756284819877606 | DOI Listing |
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