Work

Vacuum-assisted self-expanding stents in colorectal surgery: early experiences with a novel tool

Year: 2025

Type: article

Abstract: BACKGROUND: Anastomotic leakage (AL) remains a dreaded complication following colorectal resections. The routine use of diverting loop ileostomies (DLI), is associated with significant morbidity, triggering interest in alternative strategies. The VACStent Colon (VSC), a novel endoscopic treatment, combines vacuum-assisted closure with a self-expanding stent, providing luminal patency. Here we report our 1-year experience with the VSC. METHODS: Retrospective analysis of patients treated with VSC at our department from 02/2024 to 03/2025 either therapeutically for AL or prophylactically in high-risk anastomoses. Outcomes, including continuous luminal patency by VSC, AL healing, complications, and need for DLI, were assessed with follow-up until endoscopic healing (EH) of AL. RESULTS: Thirteen patients received a total of 47 VSC. Continuous luminal patency was achieved in 89.4%. Overall, 10 patients were treated with therapeutic intent (43 VSC). Nine patients achieved EH under VSC therapy (6 with DLI close, 2 awaiting DLI, one managed without DLI). One patient did not achieve EH. Three patients underwent prophylactic VSC therapy following high-risk anastomoses without a DLI. Notably, no AL occurred in this group. The most commonly observed complication was pain, particularly in distally placed VSC. Outpatient VSC therapy was successfully implemented in select cases. CONCLUSION: VSC shows promising results as therapeutic tool for treating colorectal AL and as prophylactic measure in high-risk anastomoses. It offers the benefits of vacuum therapy combined with mechanical stenting providing luminal patency, potentially reducing the need for DLI.

Source: Surgical Endoscopy

DOI: 10.1007/s00464-025-12116-2

Authors: Michaela Ramser, Simon Nennstiel, Matteo Mueller, Christoph Schlag, Matthias Turina

Institution: University Hospital Zurich

Language: English

Topic: Colorectal Cancer Surgical Treatments

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,390