Anastomotic leak represents an important complication following colorectal resection (3-19% frequency) with a mortality rate varying from to 1.7% to 16.4%. The endoluminalvacuum-assisted therapy (EVT) was introduced to treat presacral anastomotic abscesses.The principle is based on the application of negative pressure to drain, to clean, to inducegranulation tissue and to prevent the development of chronic sinus.

Between January 2023 and November 2025, 11 patients with anastomotic leakagefollowing low anterior resection were treated with EVT. We investigatedpotential factors related to the development of clean leading to cavity closure.

Colorectal anastomoses were located at a variable distance from the anal verge, ranging from 3 to 5 cm. All patients had a diverting ileostomy.  The diagnosis of leakage was performed after a median interval of 2 weeks, the median size of the cavity was 8 cm.

The median duration of therapy was 35 days with a mean number of 10 EVT replacements.

No complications were recorded.

Interval between the diagnosis of the complication and the start of EVT is the main determinant of outcome, with a strong negative correlation with complete orifice closure (r –0.886, p<0,001). Age, BMI, distance from the anal verge, cavity length, and number of sponge replacements exhibited weak correlations. A slight positive correlation was observed between initial orifice diameter (r = +0.266, p<0,05).

EVT seems an effective, minimally invasive procedure to treat anastomotic leakage. The treatment timeliness is crucial for achieving complete closure, underscoring the importance of an early approach of leaks.