The University of Toledo Translation Journal of Medical Sciences 
Gastroenterology Abstract, Department of Medicine Research Symposium UTJMS 2023 May 05; 11(1):e1-e1 

Use of Endoscopic Vacuum Therapy to 
Repair Colonic Anastomotic Leaks: A Meta 
Analysis 
David Farrow 1*, Matthew Agnew1, Bryanna Jay1, Sudheer Dhoop1, Wasef Sayeh1, 
Amna Iqbal1, Justin Chuang1, Azizullah A. Beran1, Sami Ghazaleh2

1Division of Internal Medicine, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 
2Division of Gastroenterology and Hepatology, Department of Medicine, The 
University of Toledo, Toledo, OH 43614 

*Corresponding author: david.farrow@utoledo.edu

Published: 05 May 2023 

Introduction: Endoscopic vacuum therapy (EVT) has recently emerged as a treatment modality for 
patients who experience anastomotic leak after surgery with an incidence of 6-30%. Treatment of 
anastomotic leaks using EVT in the upper gastrointestinal tract has been well documented. However, 
EVT for colorectal leaks remains a less studied entity. EVT is based on applying sponges to the area of 
the leak and negative pressure is applied to draw off fluid from the leak and help promote granulation 
tissue formation and healing. Our study aims to use prospective studies to assess the success and rates of 
adverse events using EVT for colo-rectal anastomotic leaks. 

Methods: Pubmed, Embase and Cochrane were searched from inception to April 2022 for prospective 
studies reporting success and adverse event rates for EVT used for colo-rectal anastomotic leaks. Using 
I2 we assessed heterogeneity and calculated 95% confidence intervals using fixed or random effect 
models. 

Results: Seven studies involving 368 patients were included in our analysis. Indication for surgery was 
malignancy in all cases. The total clinical success rate was 90.5% (CI: 87.6-93.5. I2 = 0%). The adverse 
event rate among all studies was 7% (95% CI: 4.4-9.5%, I2 = 0%). 6 patients required further surgical 
intervention and 2 required CT guided drain placement. No mortality was reported. 

Conclusion: EVT is an emerging treatment option for anastomotic leak. Our study demonstrates the 
safety and efficacy of EVT as an option for patients who experience colorectal anastomotic leak, 
however large prospective studies are warranted for further evaluation. 

https://dx.doi.org/10.46570/utjms.vol11-2023-665 

https://dx.doi.org/10.46570/utjms.vol11-2023-665
mailto:david.farrow@utoledo.edu