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Anastomotic leak is the most feared complication in colorectal surgery. In 2008, a new treatment modality was introduced, which consists of endoscopic placement of a vacuum sponge into the abscess cavity, connected to a negative pressure device, referred to as endoscopic vacuum therapy. A recent meta-analysis has reported an anastomotic healing rate as high as 85%.
Moreover, there is a complementary new concept defined as early surgical closure, which consists of a re-approximation of the bowel edges of the defect. Evidence is still required, but the surgical community believes that the addition of early surgical closure may improve outcomes further.
In this SOC we will review the current status of the endoscopic vacuum therapy for colorectal anastomotic leak, together with early surgical closure.
