Abstract
Background and study aims Endoscopic negative pressure therapy (ENPT) has been developed to treat gastrointestinal
leakages. Up to now, ENPT has usually been performed with open-pore polyurethane foam
drains (OPD). A big disadvantage of the OPDs is their large diameter. We have developed
a new, small-bore open-pore film drainage (OFD). Herein we report our first experience
in a case series of 16 patients.
Patients and methods OFD is constructed with a drainage tube and a very thin double-layered open-pore
drainage film (Suprasorb CNP, Drainage Film, Lohmann & Rauscher International, Germany).
The distal end of the tube is wrapped with only one layer of film. OFD is placed into
the gastrointestinal leakage site with common endoscopic techniques. The tube is connected
to an electronic vacuum device and continuous negative pressure of –125 mmHg applied.
Results From 2013 to 2016, 16 patients were treated with the new OFD device. In 10 patients,
transmural intestinal defects (4 esophageal, 4 rectum/colon, 1 duodenal, 1 pancreatic
cyst) were closed with ENPT in median time of 12 days (range 3 – 34 days). Five of
the 10 patients were treated solely with OFD devices. In five patients ENPT started
with ODP and changed to OFD when the cavity was shrunken to a channel with a small
opening. In four patients postoperative gastric reflux was eliminated for 5 to 16
days.
Conclusions Small-bore OFD opens up promising new treatment options within ENPT. OFD can be used
in endoscopic closure management of intestinal leakages in the upper and lower gastrointestinal
tract. Gastric reflux can be eliminated in an active manner. OFD can be inserted nasally.
OFD may be an adequate substitute for OPD, especially when placement of the larger
OPD is difficult.
Meeting presentations: The authorsʼ experience was first reported in an oral presentation
at the 46th Kongress der Deutschen Gesellschaft für Endoskopie und Bildgebende Verfahren
in Mannheim (DGE-BV), 17. – 19.03.2016.
