Aim: This systematic review and meta-analysis aimed to evaluate the effectiveness of Endo-Vacuum therapy (EVT) compared to standard care in managing colorectal anastomotic leakage, a serious complication following colorectal surgery.
Materials and methods: We conducted a literature search across PubMed, Embase, and the Cochrane Library for clinical studies published before October 2024. Studies compared outcomes of EVT and standard care, with reported on closure rates of anastomotic leakage, treatment duration, hospital stay duration, or postoperative complications. The pooled estimates of RR or mean differences were primarily derived using a fix-effects model,a random-effects model was employed when high heterogeneity was detected.
Results: The analysis included six observational studies, involving a total of 273 patients. EVT was associated with a significantly higher closure rate compared to standard care (RR 1.18, 95% CI 1.03-1.35, P=0.02). Treatment duration was significantly shorter in the EVT group (mean difference -30.58 days, 95% CI -43.47 to -17.70,P＜0.00001), while hospital stay duration showed no significant difference between EVT and standard care (mean difference 1.73 days, 95% CI -4.23 to 7.69,P=0.57). No statistically significant difference was found in the rate of treatment-related complications between EVT and standard care (RR 1.17, 95% CI 0.52-2.80, p=0.71).
Conclusion: This meta-analysis suggests that EVT has superior effectiveness in improving closure rates, as well as a shorter treatment duration compared to standard care for colorectal anastomotic leakage. However, this study is constrained by the lack of prospective data, the risk of selection bias and heterogeneity, requiring cautious interpretation of the findings.
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