Department of Interdisciplinary Endoscopy, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
Elisabethinum Medical Care Center, Hamburg, Germany.
Sci Rep. 2022 Jul 18;12(1):12221. doi: 10.1038/s41598-022-15732-3.
After gastrointestinal resections, leakages can occur, persist despite conventional therapy and result in enterocutaneous fistulae. We developed a combination method using flexible endoscopic techniques to seal the enteric orifice with an absorbable plug in addition to a percutaneously and fistuloscopically guided open-pore film drainage (Vac-Plug method). We retrospectively searched our endoscopy database to identify patients treated with the outlined technique. The clinical and pathological data were assessed, the method analyzed and characterized and the technical and clinical success determined. We identified 14 patients that were treated with the Vac-Plug method (4 females, 10 males with a mean age of 56 years, range 50-74). The patients were treated over a time period of 23 days (range 4-119) in between one to thirteen interventions (mean n = 5). One patient had to be excluded due to short follow-up after successful closure. Seventy-seven percent (10/13) were successfully treated with a median follow-up of 453 days (range 35-1246) thereafter. No treatment related complications occurred during the therapy. The data of the analysis showed that the Vac-Plug therapy is safe and successful in a relevant proportion of the patients. It is easy to learn and to apply and is well tolerated. In our opinion, it is a promising addition to the armamentarium of interventional methods of these difficult to treat patients. Of course, its usefulness must be further validated in larger prospective studies.
胃肠道手术后可能会发生漏液，如果经过常规治疗仍持续存在，可能会导致肠皮肤瘘。我们开发了一种联合方法，使用灵活的内镜技术，在经皮和瘘管内镜引导的多孔膜引流（Vac-Plug 方法）的基础上，用可吸收塞封闭肠口。我们回顾性地搜索了我们的内镜数据库，以确定接受该技术治疗的患者。评估了临床和病理数据，分析和描述了该方法，并确定了技术和临床成功率。我们确定了 14 名接受 Vac-Plug 方法治疗的患者（4 名女性，10 名男性，平均年龄 56 岁，范围 50-74 岁）。这些患者在 1 至 13 次干预之间接受治疗，治疗时间为 23 天（范围 4-119 天），平均干预次数为 5 次。由于成功关闭后随访时间短，有 1 名患者被排除在外。此后，77%（10/13）的患者经治疗成功，中位随访时间为 453 天（范围 35-1246 天）。在治疗过程中没有发生与治疗相关的并发症。分析数据显示，Vac-Plug 治疗在相当一部分患者中是安全且有效的。它易于学习和应用，且患者耐受性良好。我们认为，对于这些难以治疗的患者，它是一种有前途的介入治疗方法。当然，它的有效性必须在更大的前瞻性研究中进一步验证。
