Endoscopic interventions for anastomotic leaks and fistulas

Abstract

Despite continuing evolution of surgical procedures, anastomotic leaks in the gastrointestinal tract still give rise to a significant morbidity and mortality. By now, interventional endoscopic techniques allow a nonsurgical management of these complications in many cases. Stent therapy has become the standard in the management of anastomotic leaks in the upper gastrointestinal tract, and endoscopic vacuum therapy has become the standard for leaks of rectal anastomoses. Recently, two novel techniques have been added to the methods for endoscopic management of leaks and fistulas: endoscopic vacuum therapy in the upper gastrointestinal tract, which has been introduced into routine application, and the placement of over-the-scope clips (OTSC).