Remission rates of arterial hypertension, type-2 diabetes mellitus, and obstructive sleep apnea syndrome were 22%, 47%, and 28% after 5 years, respectively. Conclusion: BPD-DS is safe and effective in improving obesity-related comorbidities in older patients suffering from super obesity. (n=3) or combination of a altered Trelumina feeding tube and long segment sponge (=3), giant jejunal defect: trans corporal Dennis tube with bilateral vacuum suction pump (n=1). Giant gastric defect: mesh plug implantation and vacuum therapy (n=1). Results: In 22/23 cases it was possible to close the leakage within 1-2 weeks by combination of unusual endoscopic therapies successfully and permanent. Unfortunately in the individual with huge gastric defect occlusion had not been reached. She passed away because of septic complications. Summary: In failing of surgical restoration and regular endoscopic therapies from the leakage it had been often feasible to reach an optimistic result by changing the endoscopic gain access to from endoluminal to percutaneous gain access to with a little diameter range, using mix of vacuum therapy and additional equipment (plug, PEG or Trelumina pipe) or fresh components (open up folia drain) to get an easy and full occlusion with this challenging instances. Complicated wound curing disorder on colostoma C closure with shut adverse pressure drainage (Abstract Identification: 174) J. Mller1, T. Schorsch1, L. Braun1, W. Schulze1, C. T . Mller1, G. Loske1 1 em Katholisches Marienkrankenhaus Hamburg gGmbH /em History: Parastomal swelling with abscess development of colostomy can be – because of the close closeness towards the stoma – challenging to take care of and connected with long-term morbidity. A shut subcutanous adverse pressure therapy alternatively treatment to open up surgery is proven. Materials and strategies: Three various kinds of drainage had been utilized, which differentiate in the PF-06305591 open-pore component (oE):for the distal end of the common naso-gastral pipe either an open up pore PU-Sponge (OPD), a slim, double-layer drainage-film (OFD) or a PU-Sponge protected having a drainage-film (OPFD) was set having a suture. These components differ in size and the connection towards the wound foundation. The treatment was started using the OPD, continuing using the OPFD and finished using the OFD endoscopically. A parastomal abscess formation was opened and rinsed. After that, the open-pore drainage was built as well as the oE put into the subcutaneous abscess development. The pipe was led out with a small incision faraway through the stomy to permit usage PF-06305591 of a typical stoma handbag. The wound was surgically shut and vacuum pressure established with an electric vacuum pump (-125 mmHg, constant suction). Regular modification from the drainage program was followed with endoscopic inspection from the wound cavity to monitor curing. On the 1st changes of the procedure with large-pore OPD or OPFD (Size around 15 mm or even more) the wound needed to be opened up again to be able to renew the drainage. When the wound was shrunken and clean OFD was occur place. Using the OFD, the drainage was renewed without requiring re-opening the wound endoscopically. Results: The original OPD caused a significant debridement and reduced amount of the wound, but changing from the drainage was feasible just by re-opening the wound. The OPFD required the wound to become re-openend still, but because of FGFA the sheathed film, the connection towards the wound foundation was less extreme. Finally, the OFD endoscopically was set up and restored, an additional manipulation of your skin was not required. This therapy didn’t affect oral nourishment and helps an unimpaired function from the colostomy. Summary: Shut subcutanous adverse pressure therapy can be a minimal-invasive PF-06305591 substitute in the treating parastomal abscess development. Open in another window Picture: Materials used for the brand new technique of shut adverse pressure drainage (OPD: open up pore PU-drainage, OPFD: open up pore PU-film drainage, OFD: open up pore film drainage). The size decreases from OPD to OFD. The OFD is defined set up with.