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Open-pore film drainage (OFD): a new multipurpose tool for endoscopic negative
pressure therapy (ENPT)
#MMPMID29978007
Loske G
; Schorsch T
; Rucktaeschel F
; Schulze W
; Riefel B
; van Ackeren V
; Mueller CT
Endosc Int Open
2018[Jul]; 6
(7
): E865-E871
PMID29978007
show ga
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.
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