Abstract
BackgroundVacuum-assisted closure (VAC) is an acknowledged method of treating wound healing disorders, but has been viewed as a contraindication in therapy of intraabdominal fistulas.Case presentationWe present the case of an 83-year old patient with ureteroileal anastomotic insufficiency following cystectomy and urinary diversion by Bricker ileal conduit due to urothelial bladder cancer. After developing an open abdomen on the 16th postoperative day a leakage of the ureteroileal anastomosis appeared that cannot be managed by surgical means. To stopp the continued leakage we tried a modified VAC therapy with a silicon covered polyurethane foam under a suction of 125 mmHg. After 32 days with regularly changes of the VAC foam under general anesthesia the fistula resolved without further problems of ureteroileal leakage.ConclusionWe present the first report of VAC therapy successfully performed in urinary tract leakage after surgical treatment of bladder cancer. VAC therapy of such disorders requires greater care than of superficial application to avoid mechanical alterations of internal organs but opens new opportunities in cases without surgical alternatives.
Highlights
ConclusionWe present the first report of Vacuum-assisted closure (VAC) therapy successfully performed in urinary tract leakage after surgical treatment of bladder cancer
Vacuum-assisted closure (VAC) is an acknowledged method of treating wound healing disorders, but has been viewed as a contraindication in therapy of intraabdominal fistulas.Case presentation: We present the case of an 83-year old patient with ureteroileal anastomotic insufficiency following cystectomy and urinary diversion by Bricker ileal conduit due to urothelial bladder cancer
In the current literature the feasibility of VAC in intraabdominal fistulas is debated as mechanical alterations can cause intestinal damage [2]
Summary
We present the first report of vacuum-assisted closure therapy successfully performed in urinary tract leakage after surgical treatment of bladder cancer. Appreciated in superficial wound healing disorders VAC even may be considered in the face of lacking surgical alternatives for the closure of complex anastomotic insufficiencies
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