Post written by Sebastian Petruzzella, MSc, from the Department of Gastroenterology and Hepatology, CHUV, Lausanne’s University Hospital, Lausanne, and the Department of Surgery, Hôpital Riviera-Chablais, Rennaz, Switzerland.

Our study focused on the efficacy of endoluminal treatment of postsurgical fistulas after esophagectomy.

Not all patients are fit to be reoperated on after an anastomotic leak, and surgical reintervention may have many risks. New technologies in the endoscopy domain enable us to safely treat these leaks, and few studies have been conducted until this moment.

Our study shows how effective and safe endoscopic treatment is for this kind of fistula in a large cohort of patients. Esophagectomy patients are most of the time fragile and difficult to reoperate on.

Stenting, with vacuum therapy and other techniques used in large endoscopy centers, should be considered as first-line treatment for complicated patients in a multidisciplinary context of care. Larger prospective studies should be performed to reinforce existing evidence.

An example of a combined treatment with vacuum-assisted closure and self-expandable metal stent.

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