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Updated: Jun 18, 2026
Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
[Leakage of colorectal anastomosis after neoadjuvant therapy with bevacizumab. Case report]
S Scabini1, D Pertile, R Boaretto
1Dipartimento Emato-Oncologicao, U.O.S. Chirurgia, Oncologica e dei Sistemi Impiantabili, Azienda Ospedaliera Universitaria San Martino, Genova.
Background:
Despite progresses achieved in last decades in treatment of rectal cancer, anastomotic leakage remains the main complication.
Patients And Methods:
We report two cases of patients affected by distal rectal cancer. Both patients received neoadjuvant therapy according to ROCHE ML 18522 experimental protocol (Xeloda, Avastin and radiotherapy). After about respectively one and two months after anterior resection of the rectum, with transanal anastomosis and temporary colostomy, presacral abscess occurred. Patients were hospitalized and started antibiotic therapy. In one case it was necessary TC-guided drainage placement.
Results:
Both patients had a favourable course and, after respectively 6 months and 1 year, underwent closure of colostomy.
Discussion:
"Spontaneous" gastrointestinal microperforation (small leakage) is reported during treatment with bevacizumab, a monoclonal antibody against Vascular Endothelial Growth Factor (VEGF), also in patients with non gastrointestine tumours. Probably this results from inhibition of neoangiogenesis induced.
Conclusions:
Surgeons have to pay attention to adverse effects of combined neoadjuvant treatment of rectal cancer, considering temporary colostomy in presence of particular risk factors.
