Endoscopic Endovacuum Therapy (EVT) is a safe and efficient method for treating post-surgical collections communicating with the gastrointestinal (GI) tract [1], but it requires longer hospitalization and repeated treatments. We aim to identify clinical factors that could predict the success or failure of EVT in treating post-surgical collections.

We retrospectively analyzed patients treated with EVT in the last 2 years, comparing 2 different centers (Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; A.O.R.N. Moscati, Avellino, Italy). To avoid bias, we considered only patients who had oncological surgery of the rectum, with a diagnosis of colorectal dehiscence communicating with an extraluminal collection, and treated exclusively with EVT. The Endosponge (B. Braun Surgical) was used in all patients, with a negative continuous aspiration between 100 and 125 mmHg; the sponges were exchanged every 72±24 hours. All patients had a colostomy or ileostomy, as allowed adjuvant treatment. The success of EVT was defined as total drainage of the collection and closure of the dehiscence.

A total of 19 patients were analyzed (10 vs 9). Age, sex, and neoadjuvant treatment were comparable (62 vs 64 years; 7/10 vs 7/9 males; 5/10 vs 5/9 patients treated). The outcome was different: 50% (5/10) vs 88.8% (8/9) had complete collection drainage and dehiscence closure. Significant differences were found in timing from diagnosis of the dehiscence to the start of EVT (median of 16.5 vs 7 days), the collection’s dimensions (mean 38,8±41,6 mm vs 82.7 ± 61.5mm), and the treatment’s duration (mean 24.8 ± 15.0 vs 17,5±10,1 days). No complications observed due to EVT.

Late start of EVT and larger collection size could negatively impact the outcome of EVT. Longer treatment duration doesn’t seem to improve the results.