Rosianu Cristian Gelu, Hoara Petre, Achim Florin, Birla Rodica, Bolocan Alexandra, Mohssen Ahmed, Copca Narcis, Constantinoiu Silviu
Department of General Surgery, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Gastroenterology Department, "Sfanta Maria" Clinical Hospital, 011172 Bucharest, Romania.
Life (Basel). 2023 Apr 7;13(4):966. doi: 10.3390/life13040966.
Esophageal fistula remains one of the main postoperative complications, with the treatment often requiring the use of stents. This article reviews the updates on the use of endoscopic stents for the treatment of postoperative esophageal leakage in terms of indications, types of stents used, efficiency, specific complications and perspectives.
We searched the PubMed and MEDLINE databases for the keywords postoperative esophageal anastomotic leak and postoperative esophageal anastomotic leak stent, and retrieved relevant papers published until December 2022.
The endoscopic discovery of the fistula is usually followed by the insertion of a fully covered esophageal stent. It has an efficiency of more than 60% in closing the fistula, and the failure is related to the delayed application of the method, a situation more suitable for endo vac therapy. The most common complication is migration, but life-threatening complications have also been described. The combination of the advantages of endoscopic stents and vacuum therapy is probably found in the emerging VACstent procedure.
Although the competing approaches give promising results, this method has a well-defined place in the treatment of esophageal fistulas, and it is probably necessary to refine the indications for each individual procedure.
食管瘘仍然是主要的术后并发症之一，其治疗通常需要使用支架。本文从适应症、所用支架类型、疗效、特定并发症及前景等方面综述了内镜支架治疗术后食管漏的最新进展。
我们在PubMed和MEDLINE数据库中搜索关键词“术后食管吻合口漏”和“术后食管吻合口漏支架”，并检索截至2022年12月发表的相关论文。
内镜发现瘘口后通常会置入全覆膜食管支架。其闭合瘘口的有效率超过60%，失败与该方法应用延迟有关，这种情况更适合采用内镜负压治疗。最常见的并发症是移位，但也有危及生命的并发症报道。内镜支架和负压治疗的优势结合可能体现在新兴的VACstent手术中。
尽管其他竞争方法也取得了不错的效果，但这种方法在食管瘘治疗中占有明确的地位，可能有必要针对每个具体手术细化适应症。
