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The study aimed to assess the value of Endo-VAC in patients with pelvic sepsis.The results of Endo-VAC for pelvic sepsis were assessed. A literature search was performed to identify studies assessing the use of Endo-VAC in coloproctology.Four patients (two males, median age 48 [35-71] years) were included. Two developed pelvic sepsis followingproctectomy for ulcerative colitis and two had an anastomotic dehiscence following low anterior resection. Three patients hadprolonged history (more than 2 years) of recurrent pelvic sepsis following their operation. The median duration of treatment and length of stay was 18.5(10-23) and 22.5(10-56) days respectively. The pelvic sepsis resolved in three patients. Treatment was discontinued in one, who had a low anterior resection 2 years before the Endo-VAC treatment, due to thepresence of small bowel loops where the tip of the sponge was positioned. The literature search identified six non-randomised studies reporting success rates and mean time to cavity closure ranging from 66.6 to 100% and 40-51 days respectively.Endo-VAC treatment was safe and effective for three of the four patients with pelvic sepsis. Larger studies are required to assess its value further.