Endo-SPONGE® Clinical evidence

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10 years of experience treating anastomotic leakages with Endo-SPONGE® have obtained good results supported by clinical data.

Outcomes at a glance

Superior outcomes

  • Short treatment time compared to conventional therapies [2], [3]
  • Trend to reduce number of reintervention [4]

Improve patient quality of life

  • Ambulatory treatment possible [5], [6], [7]
  • Good patient acceptance [6], [7], [8]

Results summary

The latest series of patients using endoluminal vacuum therapy for the treatment of anastomotic leakage, after rectal resection, shows 31 days per patient as the average time required for treatment. The average of total number of sponges used per patients are 8 sponges.

The combined successful average rate meaning total healing of the leakage cavity, was 85% of the cases. [12]

Literature n Duration of therapy (days) Number of sponges Success
Nagell et al. Int J Colorectal Dis [11] 4 51 NA  100% 
Weidenhagen et al. Surg Endosc [2]  29  34  11  97% 
Glitsch et al. Endoscopy [9] 17  21  94% 
Van Koperen et al. Surg Endosc [12]  16  40  13  56% 
Riss et al. Colorectal Dis [13] 21  67% 
Nerup et al. Dan Med J [14]  13  18  100% 
Arezzo et al. Dig Liv Dis [10]  14  41  13  79% 
Kuchn et al. 2015 (in this paper)  20  23  90% 
  122  31  85% 

The different success rate on the Van Koperen et al. series of patients can be explained by the fact that the authors also included a group of patients treated with Endo-SPONGE® after 6 weeks of leakage evolution, which reduces the total success rate to 56%. Without this group the successful rate would be 75% and the total average successful rate would be 88%.


Num.  Refs Link
[1]  McDermott FD, Heeney A, Kelly ME, Steele RJ, Carlson GL, Winder DC.
Systematic review of perioperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks.
Br J Surg. 2015 Apr;102(5):462-79.Willis S, Stumpf M. Chirurg 2004, 75:1071-78.Willis S, Stumpf M. Chirurg 2004, 75:1071-78.
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[2]  Nagell CF, Holte K.
Treatment of anastomotic leakage after rectal resection with transrectalvacuum-assisted drainage (VAC). A method for rapid control of pelvic sepsis and healing.
Int J Colorectal Dis. 2006 Oct;21(7):657-60.
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[3]  Mees ST, Palmes D, Mennigen R, Senninger N, Haier J, Bruewer M.
Endo-vacuum assisted closure treatment for rectal anastomotic insufficiency.
Diseases Colon Rectum. 2008 Apr;51(4):404-10.
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[4]  Weidenhagen R, Gruetzner KU, Wiecken T, Spelsberg F, Jauch KW.
Endoluminal vacuum therapy for the treatment of anastomotic leakage after anterior rectal resection.
Rozhl Chir. 2008 Aug;87(8):397-402.
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[5]  Weidenhagen R, Gruetzner KU, Wiecken T, Spelsberg F, Jauch KW.
Endoscopic vacuum-assisted closure of anatomotic leakage following anterior resection of the rectum: a new method.
Surg Endosc. 2008 Aug;22(8):1818-25.
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[6]  Riss S, Stift A, Meier M, Haiden E, Grünberger T, Bergmann M.
Endo-SPONGE® assisted treatment of anatomotic leakage following colorectal surgery.
Colorectal Dis. 2010 Jul;12 (7 Online):e104-8.
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[7]  Arezzo A, Verra M, Passera R, Bullano A, Rapetti L, Morino M.
Long-term efficacy of endoscopic vacuum therapy for the treatment of colorectal anastomotic leaks.
Dig Liver Dis. 2015 Apr;47(4):342-5.
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[8]  Strangio G, Zullo A, Ferrara EC, Anderloni A, Carlino A, Jovani M, Ciscato C, Hassan C, Repici A.
Endo-SPONGE® therapy for management of anastomotic leakages after colorectal surgery: A case series and review of the literature.
Dig Liver Dis. 2015 Jun;47(6):465-9.
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[9]  Schintler MV.
Negative pressure therapy: theory and practice.
Diabetes Metab Res Rev. 2012 Feb;28 Suppl 1:72-7.
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[10]  Tricco AC, Antony J, Vafaei A, Khan PA, Harrington A, Cogo E, Wilson C, Perrier P, Hui W, Starus SE.
Seeking effective interventions to treat complex wounds: an overview of systematic reviews.
BMC Med. 2015 Apr;22;13:89.
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[11]  Nerup N, Johansen JL, Alkhefagie GA, Maina P, Jensen KH.
Promising results after endoscopic vacuum treatment of anastomotic leakage following resection of rectal cancer with ileostomy.
Dan Med J. 2013 Apr;60(4):A4604.
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[12]  Kuehn F, Janisch F, Schwandner F, Alsfasser G, Schiffnann L, Gock M, Klar E.
Endoscopic Vacuum Therapy in Colorectal Surgery.
J Gastrointest Surg. 2016 Feb;20(2):328-34.
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  [13] Willis S, Stumpf M.
Leakages after surgery of the lower gastrointestinal tract
Chirurg 2004, 75:1071-78.
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