EP540 - Enhancing Surgical Outcomes: Rizal Medical Center’s Experience with Endo-sponge Therapy for Colorectal Anastomotic Leaks

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Purpose/Background: Background: Anastomotic leaks following colorectal surgery, particularly in patients who have undergone total neoadjuvant therapy, represent a severe complication associated with significant morbidity and mortality. Endosponge therapy, which involves endoscopic application of a negative pressure system, has emerged as a promising minimally invasive intervention for managing these complex cases. This study evaluates its implementation in a clinical setting.

Methods/Interventions:

Methods: Between January and October 2025, four patients (age range 40-60 years) who developed anastomotic leaks following low anterior resection for low rectal adenocarcinoma after total neoadjuvant therapy were enrolled. The endoscopic endosponge procedure involved placing a polyurethane sponge directly into the leak cavity, connected to a portable vacuum pump for continuous negative pressure. Sponge changes were performed systematically every 4 days. Once adequate granulation is present, Trans anal primary repair using Transanal Access Platform was used ensuring optimal visualization and instrument mobility.

Results/Outcomes: Endosponge therapy successfully facilitated anastomotic salvage in all four patients (100%). No procedure-related complications, such as sponge migration, bleeding, or patient intolerance, were observed throughout the treatment courses.

Conclusion/Discussion: The initial experience at Rizal Medical Center indicates that endosponge therapy is a safe and highly effective treatment for colorectal anastomotic leaks. This technique provides a reliable method for anastomotic salvage, effectively controls localized sepsis, and avoids the need for more invasive re-operative surgery. These findings support its integration as a valuable tool in the management of this challenging surgical complication.