{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T17:46:00Z","timestamp":1785865560972,"version":"3.56.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"VACStent GmbH, Fulda"},{"name":"Private Universit\u00e4t Witten\/Herdecke gGmbH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previously, the treatment of colorectal anastomotic insufficiencies with endoluminal vacuum therapy (EVT) was not feasible without creating a diverting stoma, as the suction sponge typically obstructed the intestinal lumen. However, clinical use of the VacStent GI\u2122 in the upper gastrointestinal tract has demonstrated that secure closure of intestinal wall defects or anastomotic leaks, along with effective drainage of associated wound cavities, is achievable via intraluminal EVT. The innovative concept of the VacStent GI\u2122 was now transferred to the lower GI tract.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A prospective multicenter feasibility study was conducted, with the primary endpoint being the safe and practical application of the device, complete coverage of the leak, and effective suction-based treatment of colorectal leaks. Secondary endpoints included the prevention of septic complications, avoidance of stoma creation, successful leak healing, and the assessment of adverse events such as stent migration, local erosion or ulceration, and bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fourteen patients with postoperative colorectal anastomotic leaks and one with iatrogenic instrumental perforation were enrolled in two German hospitals. A total of 43 VacStent GI\u2122 Colon were implanted, with a median of three VacStent per patient and a median treatment duration of 14\u00a0days. The safe and practical application of the VacStent GI\u2122 Colon was achieved in all implantations, resulting in a leak healing rate of 93.3% (14\/15 patients). There were no severe device-related adverse events (SADE) nor significant local bleeding or erosion. The creation of a diverting stoma was not necessary in any of the patients.<\/jats:p>\n                    <jats:p>Minor stent-dislocation and migration, respectively, was observed in 4.7%. Three anastomotic stenoses were seen during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clinical use of the VacStent GI\u2122 Colon\u00a0in the lower gastrointestinal tract demonstrates that anastomotic colonic leaks can be effectively treated, potentially avoiding the need for a diverting stoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-13239-w","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:43:38Z","timestamp":1785861818000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of colorectal leaks with the VACStent-Colon: results of the VACStent feasibility trial"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4562-9924","authenticated-orcid":false,"given":"Alexander","family":"Yohannes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Lange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Knievel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Brunner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alois","family":"F\u00fcrst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"H\u00fcgle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arno J.","family":"Dormann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus F.","family":"Eisenberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus M.","family":"Heiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"13239_CR1","unstructured":"Broemel IT. (2024) Untersuchung zu \u00e4tiologischen Faktoren der Anastomoseninsuffizienz nach Rektumresektion\u2013\u2013eine retrospektive Analyse. [M\u00fcnchen]: Ludwigs-Maximilian Universit\u00e4t M\u00fcnchen"},{"key":"13239_CR2","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1055\/s-0041-1735271","volume":"34","author":"TL Hedrick","year":"2021","unstructured":"Hedrick TL, Kane W (2021) Management of acute anastomotic leaks. Clin Colon Rectal Surg 34:400\u2013405. https:\/\/doi.org\/10.1055\/s-0041-1735271","journal-title":"Clin Colon Rectal Surg"},{"key":"13239_CR3","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2023.1168541","author":"C Sch\u00e4fer","year":"2023","unstructured":"Sch\u00e4fer C (2023) Don\u2019t be afraid of black holes: vacuum sponge and vacuum stent treatment of leaks in the upper GI tract\u2014a case series and mini-review. Front Surg. https:\/\/doi.org\/10.3389\/fsurg.2023.1168541","journal-title":"Front Surg"},{"key":"13239_CR4","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1002\/bjs5.50124","volume":"3","author":"M Shalaby","year":"2019","unstructured":"Shalaby M, Emile S, Elfeki H, Sakr A, Wexner SD, Sileri P (2019) Systematic review of endoluminal vacuum\u2010assisted therapy as salvage treatment for rectal anastomotic leakage. BJS Open 3:153\u2013160. https:\/\/doi.org\/10.1002\/bjs5.50124","journal-title":"BJS Open"},{"key":"13239_CR5","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1007\/s10151-009-0543-x","volume":"13","author":"WA Bemelman","year":"2009","unstructured":"Bemelman WA (2009) Vacuum assisted closure in coloproctology. 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BMJ Case Rep 14:e240188. https:\/\/doi.org\/10.1136\/bcr-2020-240188","journal-title":"BMJ Case Rep"},{"key":"13239_CR8","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1111\/jgh.14402","volume":"34","author":"H Kobara","year":"2019","unstructured":"Kobara H, Mori H, Nishiyama N, Fujihara S, Okano K, Suzuki Y et al (2019) Over-the-scope clip system: a review of 1517 cases over 9 years. J of Gastro and Hepatol 34:22\u201330. https:\/\/doi.org\/10.1111\/jgh.14402","journal-title":"J of Gastro and Hepatol"},{"key":"13239_CR9","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1055\/a-2019-3652","volume":"55","author":"A Krishnan","year":"2023","unstructured":"Krishnan A, Shah-Khan SM, Hadi Y, Patel N, Thakkar S, Singh S (2023) Endoscopic management of gastrointestinal wall defects, fistula closure, and stent fixation using through-the-scope tack and suture system. 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Prof Markus Heiss has a Research grant to Witten\/Herdecke University from VAC Stent GmbH. All other authors declare no competing interests.","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval by the Institutional Review Board (IRB) of Witten\/Herdecke University (No. 124\/2018) was granted. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments. All patients provided written informed consent to participate in this study.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}