Postoperative leaks in the gastrointestinal tract—diagnosis and treatment

Abstract

Postoperative leaks following esophageal, gastric, colonic or rectal resection represent a life-threatening complication that is associated with high morbidity and mortality. Leaks are generally diagnosed with a combination of the following: recognition of clinical deterioration, laboratory results, endoscopic and radiological imaging. In case of intraperitoneal leaks, surgery is mandatory. In case of mediastinal or retroperitoneal anastomotic insufficiencies, treatment mainly comprises interventional endoscopic procedures in an interdisciplinary approach. For endoscopic therapy, there are mainly two different methods described: closure of the defect with fully covered self-expandable stents with external drainage and closure of the defect with simultaneously internal drainage by endoscopic vacuum therapy.