Efficacy of the endoscopic management of postoperative fistulas of leakages after esophageal surgery for cancer: a retrospective series

Abstract

The endoscopic management of leakages or fistulas after esophageal surgery reached an efficacy rate of 68.8 %, mostly using stents, without significant adverse events. The mortality rate could be decreased from 40-100 to 17 %.

Stent placement for benign esophageal leaks, perforations, and fistulae: a clinical prediction rule for successful leakage control

“…It can therefore be discussed with the patient that the defect is unlikely to heal with stent therapy. Although evidence is scarce, alternative treatment options in this case may be endoscopic clipping or surgical repair [27,28]. A case series including patients with small (< 2 cm), mainly chronic, postoperative leaks and fistulae reported a closure rate of 89 % (8/9) after over-the-scope clip placement in the upper gastrointestinal tract [29].…”

Efficacy of Endoscopic Vacuum-Assisted Closure Treatment for Postoperative Anastomotic Leak in Gastric Cancer

“…Among those methods, SEMS insertion has been reported to have a favorable treatment success rate (>68.8% to 89.0%) for postoperative anastomotic leak in esophageal cancer. [13][14][15][16][17] However, adverse events after SEMS treatment have also been reported, such as migration, failure of stent extraction, and stricture formation after stent removal. [16][17][18][19][20] In recent years, endoscopic vacuum-assisted closure (EVAC) has been attempted as a new treatment option for postoperative fistula or anastomotic leak.…”

Surgical treatment of the severe thoracic gastrocutaneous fistula by pedicled muscle flap filling and thoracoplasty after oesophagectomy for oesophageal squamous cell carcinoma: A case report

“…In addition, the endoscopic treatment of thoracic anastomotic leakages by the placement of a covered metallic stent [[13], [14], [15]], an OTS clip or applying combined therapy after oesophagectomy for esophageal carcinoma is effective and safe [16]. And the median time of those treatment to achieve a complete healing from the diagnosis of the fistula or leakage was 44 days [16]. The disadvantages of such therapies include limited effectiveness (50–100%) and a certain malposition, as well as migration rate (10–42%) [[16], [17], [18], [19], [20], [21], [22]].…”

“…And the median time of those treatment to achieve a complete healing from the diagnosis of the fistula or leakage was 44 days [16]. The disadvantages of such therapies include limited effectiveness (50–100%) and a certain malposition, as well as migration rate (10–42%) [[16], [17], [18], [19], [20], [21], [22]].…”