AIM:To assess long-term efficacy of initially successful endo-sponge assisted therapy.METHODS:Between 2006 and 2009,consecutive patients who had undergone primary successful endo-sponge treatment of anastomotic leakag...AIM:To assess long-term efficacy of initially successful endo-sponge assisted therapy.METHODS:Between 2006 and 2009,consecutive patients who had undergone primary successful endo-sponge treatment of anastomotic leakage following rectal cancer surgery were enrolled in the study.Patients were recruited from 6 surgical departments in Vienna.Clinical and oncologic outcomes were assessed through routine endoscopic and radiologic follow-up examination.RESULTS:Twenty patients(7 female,13 male)were included.The indications for endosponge treatment were anastomotic leakage(n=17)and insufficiency of a rectal stump after Hartmann's procedure(n=3).All patients were primarily operated for rectal cancer.The overall mortality rate was 25%.The median followup duration was 17 mo(range 1.5-29.8 mo).Five patients(25%)developed a recurrent abscess.Median time between last day of endosponge therapy and occurrence of recurrent abscess was 255 d(range 21-733 d).One of these patients was treated by computed tomography-guided drainage and in 3 patients Hartmann's procedure had to be performed.Two patients(10%)developed a local tumor recurrence and subsequently died.CONCLUSION:Despite successful primary outcome,patients who receive endo-sponge therapy should be closely monitored in the first 2 years,since recurrence might occur.展开更多
AIM: To evaluate if traction-assisted endoscopic mucosal resection (TA-EMR) is feasible and if it enables en bloc resection of colorectal lesions. METHODS: Seven patients with a total of 12 colorectal adenomas were pr...AIM: To evaluate if traction-assisted endoscopic mucosal resection (TA-EMR) is feasible and if it enables en bloc resection of colorectal lesions. METHODS: Seven patients with a total of 12 colorectal adenomas were prospectively enrolled. All lesions were removed by TA-EMR: one hemostatic clip tied to a white silk suture was applied to the base of the lesion to allow traction through the working channel of the colonoscope. A conventional polypectomy snare was mounted over the suture and the lesion was pulled into the snare and resected in one piece. RESULTS: All 12 lesions (nine sessile) were resected en bloc with free lateral and vertical margins by using this novel technique, including five lesions (5/12, 41.6%) in less-accessible positions, where TA-EMR enabled complete visualization of the base before resection. Mean longest lesion and specimen sizes were 9 mm (range: 6-25 mm) and 11 mm in diameter (range: 7-17 mm),respectively. No serious procedure-related complications were observed. CONCLUSION: TA-EMR through the endoscope using a hemostatic clip and suture material is technically feasible. Visualization of colorectal lesions in less-accessible locations can be improved.展开更多
文摘AIM:To assess long-term efficacy of initially successful endo-sponge assisted therapy.METHODS:Between 2006 and 2009,consecutive patients who had undergone primary successful endo-sponge treatment of anastomotic leakage following rectal cancer surgery were enrolled in the study.Patients were recruited from 6 surgical departments in Vienna.Clinical and oncologic outcomes were assessed through routine endoscopic and radiologic follow-up examination.RESULTS:Twenty patients(7 female,13 male)were included.The indications for endosponge treatment were anastomotic leakage(n=17)and insufficiency of a rectal stump after Hartmann's procedure(n=3).All patients were primarily operated for rectal cancer.The overall mortality rate was 25%.The median followup duration was 17 mo(range 1.5-29.8 mo).Five patients(25%)developed a recurrent abscess.Median time between last day of endosponge therapy and occurrence of recurrent abscess was 255 d(range 21-733 d).One of these patients was treated by computed tomography-guided drainage and in 3 patients Hartmann's procedure had to be performed.Two patients(10%)developed a local tumor recurrence and subsequently died.CONCLUSION:Despite successful primary outcome,patients who receive endo-sponge therapy should be closely monitored in the first 2 years,since recurrence might occur.
文摘AIM: To evaluate if traction-assisted endoscopic mucosal resection (TA-EMR) is feasible and if it enables en bloc resection of colorectal lesions. METHODS: Seven patients with a total of 12 colorectal adenomas were prospectively enrolled. All lesions were removed by TA-EMR: one hemostatic clip tied to a white silk suture was applied to the base of the lesion to allow traction through the working channel of the colonoscope. A conventional polypectomy snare was mounted over the suture and the lesion was pulled into the snare and resected in one piece. RESULTS: All 12 lesions (nine sessile) were resected en bloc with free lateral and vertical margins by using this novel technique, including five lesions (5/12, 41.6%) in less-accessible positions, where TA-EMR enabled complete visualization of the base before resection. Mean longest lesion and specimen sizes were 9 mm (range: 6-25 mm) and 11 mm in diameter (range: 7-17 mm),respectively. No serious procedure-related complications were observed. CONCLUSION: TA-EMR through the endoscope using a hemostatic clip and suture material is technically feasible. Visualization of colorectal lesions in less-accessible locations can be improved.
