VacStent as an Innovative Approach in the Treatment of Anastomotic Insufficiencies and Leakages in the Gastrointestinal Tract—Review and Outlook
Alexander Yohannes,
Judith Knievel,
Jonas Lange,
Arno J. Dormann,
Ulrich Hügle,
Claus F. Eisenberger,
Markus M. Heiss
Affiliations
Alexander Yohannes
Center for Interdisciplinary Visceral Medicine, Department of Gastroenterology, Gastrointestinal Oncology, Gastrointestinal Infections and Nutritional Medicine, Cologne-Holweide and Merheim Medical Centers, 51109 Cologne, Germany
Judith Knievel
Center for Interdisciplinary Visceral Medicine, Department of Abdominal, Tumor, Transplant and Vascular Surgery, Cologne-Merheim Medical Center, Witten/Herdecke University, 51109 Cologne, Germany
Jonas Lange
Center for Interdisciplinary Visceral Medicine, Department of Abdominal, Tumor, Transplant and Vascular Surgery, Cologne-Merheim Medical Center, Witten/Herdecke University, 51109 Cologne, Germany
Arno J. Dormann
Center for Interdisciplinary Visceral Medicine, Department of Gastroenterology, Gastrointestinal Oncology, Gastrointestinal Infections and Nutritional Medicine, Cologne-Holweide and Merheim Medical Centers, 51109 Cologne, Germany
Ulrich Hügle
Center for Interdisciplinary Visceral Medicine, Department of Gastroenterology, Gastrointestinal Oncology, Gastrointestinal Infections and Nutritional Medicine, Cologne-Holweide and Merheim Medical Centers, 51109 Cologne, Germany
Claus F. Eisenberger
Center for Interdisciplinary Visceral Medicine, Department of Abdominal, Tumor, Transplant and Vascular Surgery, Cologne-Merheim Medical Center, Witten/Herdecke University, 51109 Cologne, Germany
Markus M. Heiss
Center for Interdisciplinary Visceral Medicine, Department of Abdominal, Tumor, Transplant and Vascular Surgery, Cologne-Merheim Medical Center, Witten/Herdecke University, 51109 Cologne, Germany
Anastomotic insufficiencies are severe complications of abdominal surgery, often leading to prolonged hospitalization, serious tissue inflammation, and even sepsis, along with the need for recurrent surgery. Current non-surgical treatments such as self-expanding metal stents (SEMSs) and endoscopic vacuum therapy (EVT) have limitations, including stent migration or perforation. This review evaluates the effectiveness of the VacStent GITM (Möller Medical GmbH, Fulda, Germany), a novel medical device combining SEMS and negative-pressure wound therapy in treating gastrointestinal leaks. Data were gathered from four prospective studies and compared with existing treatments. Studies on the VacStent GITM application demonstrate technical success and competitive closure rates in upper gastrointestinal leaks, with minimal complications reported. Comparative analyses with SEMS and EVT reveal promising and most importantly equally good outcomes while maintaining the possibility for sustained enteral nutrition and reducing the risk of stent migration. The VacStent GITM presents a promising alternative to current non-surgical treatments. Ongoing research aims to validate its efficacy in lower gastrointestinal leaks and comprehensively establish its role in leak management. Further investigation is necessary to confirm these findings and optimize treatment protocols. Future usages of the VacStent GITM in colonic anastomotic insufficiencies promise an effective approach and might be able to lower the rates of necessary implementations of a stoma.
