The Dutch multicenter experience of endo-sponge treatment for anastomotic leakage after colorectal surgery

Background Anastomotic leakage is a feared complication following colorectal surgery and is associated with early and long-term morbidity and mortality. The presacral cavity as the result of anastomotic leakage can be treated with an endo-sponge (B-Braun Medical). The aim was to assess the effectiveness of endo-sponge treatment of the presacral cavity as result of anastomotic leakage in the Netherlands. Methods Between July 2006 and April 2008, 16 patients (M/F = 9:7) with a median age of 64 years, (range 19-78 years) who underwent surgery for rectal cancer (n=13), or ulcerative colitis (n=3) were treated with the endo-sponge treatment after anastomotic leakage. Results Of the 16 patients, eight patients started with the endo-sponge treatment within six weeks after the initial surgery. In these patients the endo-sponge was placed after a median of 24 days (range 13-39) following surgery. In the remaining eight patients the endo-sponge treatment was started later than six weeks after the initial surgery. In this group there was a median of 74 days (range 43-1602) between surgery and the start of the endo-sponge placement. There was closure in six out of eight patients (75%) in the group that started with the endo-sponge treatment within six weeks of surgery compared to three out of eight patients (38%) in the group that started later (p=0.315). Closure was achieved in a median of 40 (range 28-90) days with a median amount of 13 sponge replacements (range 8-17). Conclusions Endo-sponge placement can be helpful in the treatment for anastomotic leakage after colorectal surgery and might prevent a chronic presacral sinus. However, it is not yet clear if this new treatment modality results in quicker healing.