This was addressed by Weidenhagen and colleagues, who established in 2003 the successful use of the endoscopic negative pressure therapy for treatment of rectal anastomotic leakages and later by Loske and colleagues in 2010 who had shown its benefit for upper GI leakages 5, 6. In most parts of the world, the implantation of self-expandable metal stents (SEMS) is the gold standard in the therapy of esophageal and gastric leakages, but especially in older leaks (> 48 h old) a recurrent or permanent cleaning and drainage of the abscess cavity is required. These methods include endoscopic vacuum therapy, stenting and closing procedures such as clipping, suturing, fibrin glue application, and absorbable plug insertion with variable success rates of up to 95% 2, 3, 4. Therefore, several conservative and especially interventional-endoscopic- approaches were developed during the last few years 1, 2. The optimal therapy of these fistulas is under debate, surgical solutions are often avoided due to the reduced general condition of the patients and the feared physical trauma of an early surgical re-intervention. Leakages of gastrointestinal (GI) anastomoses and resection lines can result in acute and chronic entero-cutaneous fistula, leading to recurrent septic complications and possibly inadequate enteral nutrition. Of course, its usefulness must be further validated in larger prospective studies. In our opinion, it is a promising addition to the armamentarium of interventional methods of these difficult to treat patients. It is easy to learn and to apply and is well tolerated. The data of the analysis showed that the Vac-Plug therapy is safe and successful in a relevant proportion of the patients. No treatment related complications occurred during the therapy. Seventy-seven percent (10/13) were successfully treated with a median follow-up of 453 days (range 35–1246) thereafter. One patient had to be excluded due to short follow-up after successful closure. The patients were treated over a time period of 23 days (range 4–119) in between one to thirteen interventions (mean n = 5). We identified 14 patients that were treated with the Vac-Plug method (4 females, 10 males with a mean age of 56 years, range 50–74). The clinical and pathological data were assessed, the method analyzed and characterized and the technical and clinical success determined. We retrospectively searched our endoscopy database to identify patients treated with the outlined technique. We developed a combination method using flexible endoscopic techniques to seal the enteric orifice with an absorbable plug in addition to a percutaneously and fistuloscopically guided open-pore film drainage (Vac-Plug method). For help with Installation, license issues or technical support, please contact the ITS Service Desk.After gastrointestinal resections, leakages can occur, persist despite conventional therapy and result in enterocutaneous fistulae. Statistical Consulting is available through the MacOdrum Library. You must login with your MC1 credentials to gain access to this website. SPSS Statistics and Amos Licenses and software are now available for download, please go to: ![]() There is a 30-day grace period at the end of the annual licenses, which is good until the end of January 2023. License Term period: Decem– December 31, 2022. This license is an annual subscription and new authorization keys must be applied each year (mid-Dec/Jan). Users can choose either the graphical user interface or non-graphical, programmatic interface.įaculty, Staff and Students on/off campus Build models more accurately than with standard multivariate statistics techniques. IBM SPSS Amos enables you to specify, estimate, assess and present models to show hypothesized relationships among variables. ![]() ![]() IBM SPSS Statistics Base, includes: Linear Models, Nonlinear Models, Customized Tables, Categorical and Numeric Data, Data Preparation, Data Validity and Missing Values, Decision Trees, Forecasting, Structural Equation Modeling, Bootstrapping, Advanced Sampling Assessment and Testing, Direct Marketing and Product Decision Making Procedures, and High-end Charts and Graphs. Whether your focus is survey or market research, finance, manufacturing, resource planning or database analysis. IBM SPSS Statistics Premium and IBM SPSS AMOSīe ready for any analytical project throughout your enterprise-no matter the focus of your analysis.
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