Endoscopic Management of Postoperative Esophageal and Upper GI Defects—A Narrative Review
Anastomotic defects are deleterious complications after either oncologic or bariatric surgery, leading to high morbidity and mortality. Besides surgical revision in early stages or instable patients, endoscopic treatment has become the mainstay. To date, many options for endoscopic treatment in this...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/1/136 |
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| author | Cecilia Binda Carlo Felix Maria Jung Stefano Fabbri Paolo Giuffrida Monica Sbrancia Chiara Coluccio Giulia Gibiino Carlo Fabbri |
| author_facet | Cecilia Binda Carlo Felix Maria Jung Stefano Fabbri Paolo Giuffrida Monica Sbrancia Chiara Coluccio Giulia Gibiino Carlo Fabbri |
| author_sort | Cecilia Binda |
| collection | DOAJ |
| description | Anastomotic defects are deleterious complications after either oncologic or bariatric surgery, leading to high morbidity and mortality. Besides surgical revision in early stages or instable patients, endoscopic treatment has become the mainstay. To date, many options for endoscopic treatment in this setting exist, including fully covered metal stent placement, endoscopic vacuum therapy (EVT), endoscopic internal drainage with pigtail placement (EID), leak closure with through the scope or over the scope clips, endoluminal suturing, fibrin glue sealing and a combination of all these techniques. Current evidence is mostly based on retrospective single and multicenter studies. No guidelines exist in this important field. Treatment options have to be chosen upon each case individually, taking into account clinical and anatomic criteria, such as timing, size, infectious wound complications and hemodynamic stability. Local expertise and availability of treatment devices need to be taken into account whenever choosing a treatment strategy. This review aimed to present current treatment options in terms of effectiveness, advantages and disadvantages in order to guide the clinician for his decision making. Additionally, we aimed to provide a treatment algorithm. |
| first_indexed | 2024-03-09T11:44:25Z |
| format | Article |
| id | doaj.art-4f962f33587742b8b43b8bd598f0c78c |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T11:44:25Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-4f962f33587742b8b43b8bd598f0c78c2023-11-30T23:24:51ZengMDPI AGMedicina1010-660X1648-91442023-01-0159113610.3390/medicina59010136Endoscopic Management of Postoperative Esophageal and Upper GI Defects—A Narrative ReviewCecilia Binda0Carlo Felix Maria Jung1Stefano Fabbri2Paolo Giuffrida3Monica Sbrancia4Chiara Coluccio5Giulia Gibiino6Carlo Fabbri7Gastroenterology and Digestive Endoscopy Unit, Forli—Cesena Hospitals, AUSL Romagna, 47121 Forlì Cesena, ItalyGastroenterology and Digestive Endoscopy Unit, Forli—Cesena Hospitals, AUSL Romagna, 47121 Forlì Cesena, ItalyGastroenterology and Digestive Endoscopy Unit, Forli—Cesena Hospitals, AUSL Romagna, 47121 Forlì Cesena, ItalyDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, ItalyGastroenterology and Digestive Endoscopy Unit, Forli—Cesena Hospitals, AUSL Romagna, 47121 Forlì Cesena, ItalyGastroenterology and Digestive Endoscopy Unit, Forli—Cesena Hospitals, AUSL Romagna, 47121 Forlì Cesena, ItalyGastroenterology and Digestive Endoscopy Unit, Forli—Cesena Hospitals, AUSL Romagna, 47121 Forlì Cesena, ItalyGastroenterology and Digestive Endoscopy Unit, Forli—Cesena Hospitals, AUSL Romagna, 47121 Forlì Cesena, ItalyAnastomotic defects are deleterious complications after either oncologic or bariatric surgery, leading to high morbidity and mortality. Besides surgical revision in early stages or instable patients, endoscopic treatment has become the mainstay. To date, many options for endoscopic treatment in this setting exist, including fully covered metal stent placement, endoscopic vacuum therapy (EVT), endoscopic internal drainage with pigtail placement (EID), leak closure with through the scope or over the scope clips, endoluminal suturing, fibrin glue sealing and a combination of all these techniques. Current evidence is mostly based on retrospective single and multicenter studies. No guidelines exist in this important field. Treatment options have to be chosen upon each case individually, taking into account clinical and anatomic criteria, such as timing, size, infectious wound complications and hemodynamic stability. Local expertise and availability of treatment devices need to be taken into account whenever choosing a treatment strategy. This review aimed to present current treatment options in terms of effectiveness, advantages and disadvantages in order to guide the clinician for his decision making. Additionally, we aimed to provide a treatment algorithm.https://www.mdpi.com/1648-9144/59/1/136endoscopic treatment of anastomotic defectsesophageal fistulaperforationesophageal leakage |
| spellingShingle | Cecilia Binda Carlo Felix Maria Jung Stefano Fabbri Paolo Giuffrida Monica Sbrancia Chiara Coluccio Giulia Gibiino Carlo Fabbri Endoscopic Management of Postoperative Esophageal and Upper GI Defects—A Narrative Review Medicina endoscopic treatment of anastomotic defects esophageal fistula perforation esophageal leakage |
| title | Endoscopic Management of Postoperative Esophageal and Upper GI Defects—A Narrative Review |
| title_full | Endoscopic Management of Postoperative Esophageal and Upper GI Defects—A Narrative Review |
| title_fullStr | Endoscopic Management of Postoperative Esophageal and Upper GI Defects—A Narrative Review |
| title_full_unstemmed | Endoscopic Management of Postoperative Esophageal and Upper GI Defects—A Narrative Review |
| title_short | Endoscopic Management of Postoperative Esophageal and Upper GI Defects—A Narrative Review |
| title_sort | endoscopic management of postoperative esophageal and upper gi defects a narrative review |
| topic | endoscopic treatment of anastomotic defects esophageal fistula perforation esophageal leakage |
| url | https://www.mdpi.com/1648-9144/59/1/136 |
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