PMID- 34466357
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210903
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 9
IP  - 9
DP  - 2021 Sep
TI  - Endo-sponge in management of anastomotic colorectal leaks: a systematic review 
      and meta-analysis.
PG  - E1342-E1349
LID - 10.1055/a-1490-8783 [doi]
AB  - Background and study aims  Following colorectal surgery, anastomotic dehiscence 
      and leak formation has an incidence of 2 % to 7 %. Endo-SPONGE has been applied 
      in the management of anastomatic leaks (ALs) after colorectal surgery. This is 
      the first systematic review and meta analysis to evaluate the efficacy and safety 
      of Endo-SPONGE in the management of colorectal ALs. Patients and methods  The 
      primary outcomes assessed were the technical and clinical success of Endo-SPONGE 
      placement in colorectal ALs. The secondary outcomes assessed were the overall 
      adverse events (AEs) and the AE subtypes. Pooled estimates were calculated using 
      random-effects models with 95 % confidence interval (C. I.). The statistical 
      analysis was done using STATA v16.1 software (StataCorp, LLC College Station, 
      Texas, United States). Results  The analysis included 17 independent cohort 
      studies with a total of 384 patients. The rate of technical success was 99.86 % 
      (95 % CI: 99.2 %, 100 %; P  = 0.00; I (2)  = 70.69 %) and the calculated pooled 
      rate of clinical success was 84.99 % (95 % CI: 77.4 %, 91.41 %; P  = 0.00; I (2) 
       = 68.02 %). The calculated pooled rate of adverse events was 7.6 % (95 % CI: 
      3.99 %, 12.21 %; P  = 0.03; I (2)  = 42.5 %) with recurrent abscess formation and 
      bleeding being the most common AEs. Moderate to substantial heterogeneity was 
      noted in our meta-analysis. Conclusions  Endoscopic vacuum therapy appears to be 
      a minimally invasive, safe, and effective treatment modality for patients with a 
      significant colorectal leak without any generalized peritonitis with high 
      clinical and technical success rates and a low rate of adverse events. Further 
      prospective or randomized controlled trials are needed to validate our findings.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Dhindsa, Banreet S
AU  - Dhindsa BS
AD  - Division of Gastroenterology and Hepatology, University of Nebraska Medical 
      Center, Omaha Nebraska, United States.
FAU - Naga, Yassin
AU  - Naga Y
AD  - University of Nevada Las Vegas School of Medicine, Las Vegas, Nevada, United 
      States.
FAU - Saghir, Syed M
AU  - Saghir SM
AD  - University of Nevada Las Vegas School of Medicine, Las Vegas, Nevada, United 
      States.
FAU - Daid, Sarav Gunjit Singh
AU  - Daid SGS
AD  - Metropolitan Hospital Center/New York Medical College, New York, New York, United 
      States.
FAU - Chandan, Saurabh
AU  - Chandan S
AD  - Creighton University Medical Center, Omaha, Nebraska, United States.
FAU - Mashiana, Harmeet
AU  - Mashiana H
AD  - Division of Gastroenterology and Hepatology, University of Nebraska Medical 
      Center, Omaha Nebraska, United States.
FAU - Dhaliwal, Amaninder
AU  - Dhaliwal A
AD  - Division of Gastroenterology and Hepatology, Moffitt Cancer Center, Tampa, 
      Florida, United States.
FAU - Sidhu, Abhitej
AU  - Sidhu A
AD  - Bharati Vidyapeeth University Medical College, Pune, Maharashtra, India.
FAU - Sayles, Harlan
AU  - Sayles H
AD  - Department of Biostatistics, University of Nebraska Medical Center, Omaha, 
      Nebraska, United States.
FAU - Ramai, Daryl
AU  - Ramai D
AD  - Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New 
      York, United States.
FAU - Bhat, Ishfaq
AU  - Bhat I
AD  - Division of Gastroenterology and Hepatology, University of Nebraska Medical 
      Center, Omaha Nebraska, United States.
FAU - Singh, Shailender
AU  - Singh S
AD  - Division of Gastroenterology and Hepatology, University of Nebraska Medical 
      Center, Omaha Nebraska, United States.
FAU - McDonough, Stephanie
AU  - McDonough S
AD  - Division of Gastroenterology and Hepatology, University of Utah School of 
      Medicine, Salt Lake City, Utah, United States.
FAU - Adler, Douglas G
AU  - Adler DG
AD  - Division of Gastroenterology and Hepatology, University of Utah School of 
      Medicine, Salt Lake City, Utah, United States.
LA  - eng
PT  - Journal Article
DEP - 20210816
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC8367445
COIS- Competing interests The authors declare that they have no conflicts of interest.
EDAT- 2021/09/02 06:00
MHDA- 2021/09/02 06:01
PMCR- 2021/08/01
CRDT- 2021/09/01 07:24
PHST- 2021/01/05 00:00 [received]
PHST- 2021/03/29 00:00 [accepted]
PHST- 2021/09/01 07:24 [entrez]
PHST- 2021/09/02 06:00 [pubmed]
PHST- 2021/09/02 06:01 [medline]
PHST- 2021/08/01 00:00 [pmc-release]
AID - 10.1055/a-1490-8783 [doi]
PST - epublish
SO  - Endosc Int Open. 2021 Aug 16;9(9):E1342-E1349. doi: 10.1055/a-1490-8783. 
      eCollection 2021 Sep.