Conclusions
NECROTIC DEBRIS
In this study, the VARTD was performed as safely as the currently preferred minimal-access surgical approaches for the treatment of infected WON; the VARTD combined with continuous postoperative lavage showed a good efficacy for evacuating necrotic debris while avoiding additional interventions; thus, this approach may be an option for selected patients especially the ones developed the iWONde after failure of the “step-up” approach. To test these findings further, a large-scale, randomized trial involving multiple institutions and comparing the effects of the VARTD with other minimal-access techniques on outcomes of patients who had developed iWONde is warranted.