Purpose: Endoluminal vacuum sponge therapy has dramatically improved the treatment of anastomotic leaks in esophageal surgery. However, the blind insertion of vacuum sponge kits like Eso-Sponge® via an overtube and a pusher can be technically difficult.
Methods: We therefore insert our sponges under direct visual control by a nonstandard "piggyback" technique that was initially developed for the self-made sponge systems preceding these commercially available kits.
Results: Using this technique, we inserted or changed 56 Eso-Sponges® in seven patients between 2018 and 2023. Apart from one secondary sponge dislocation, no intraprocedural complications were encountered. One patient died due to unrelated reasons. In all others, the defects healed and they were dismissed from the hospital. Long-term follow-up showed three strictures that were successfully treated by dilatation.
Conclusion: We conclude that sponge placement via piggyback technique is a fast, safe, and successful alternative to the standard method of insertion.
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http://dx.doi.org/10.1007/s00423-024-03272-5 | DOI Listing |
Med J Malaysia
January 2025
Saveetha Institute of Medical and Technical Sciences, SIMATS Deemed University, Chennai, Tamilnadu, India.
Barotrauma is a medical condition caused by sudden pressure changes in the body causing damage to multiple parts of the body. However, it is an infrequent occurrence when it comes to Colo-rectal perforation, wherein the trauma occurs due to the insufflation of compressed air through the anus. Several factors influence the outcome of a patient with colonic perforation due to barotrauma such as the severity of the injury, hemodynamic status of the patient, the patient's general health and well-being, the time taken for active medical/ surgical intervention since the injury, aggressive intravenous antibiotics administration to prevent sepsis, post-operative complications like surgical site infection, post-op ileus, anastomotic leak, etc.
View Article and Find Full Text PDFBMC Surg
January 2025
State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing, China.
Background: Anastomotic leakage (AL) is a serious complication that may occur following the double stapling technique (DST). The study aims to investigate the efficacy of anastomotic reinforcement using barbed sutures in preventing AL after laparoscopic low anterior resection (LAR) for rectal cancer.
Methods: During the period from November 1, 2018 to November 1, 2023, a total of 725 consecutive patients who had underwent laparoscopic LAR for rectal cancer were enrolled in this study.
Surg Innov
January 2025
Leeds Institute of Medical Research, St James's University Hospital, University of Leeds, Leeds, UK.
Introduction: Anastomotic leak (AL) represents a significant complication following gastrointestinal (GI) surgery, contributing to increased morbidity and mortality. pH monitoring has emerged as a potential diagnostic tool for the early detection of AL, but its effectiveness and clinical utility remain to be fully elucidated. This review aims to summarise the evidence regarding perianastomotic pH monitoring for AL detection.
View Article and Find Full Text PDFAbdom Radiol (NY)
January 2025
University of Virginia, Charlottesville, USA.
Colorectal Dis
January 2025
Colorectal Surgery Unit, General Surgery Department, Marqués de Valdecilla University Hospital, Santander, Spain.
Aim: Complete mesocolic excision (CME) is an oncologically driven technique for treating right colon cancer. While laparoscopic CME is technically demanding and has been associated with more complications, the robotic approach might reduce morbidity. The aim of this study was to assess the safety of stepwise implementation of robotic CME.
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