Copyright
©The Author(s) 2020.
World J Gastroenterol. Aug 7, 2020; 26(29): 4198-4217
Published online Aug 7, 2020. doi: 10.3748/wjg.v26.i29.4198
Published online Aug 7, 2020. doi: 10.3748/wjg.v26.i29.4198
Table 2 Main features of the different endoscopic approaches to leak and fistula
Mechanism ofaction | Advantages | Disadvantages | Cost | N° of sessions | Expertise needed | |
Endoclips | Direct closure | More effective in acute setting | Less effective in chronic setting; Need of external drainage | + | + | + |
Stent | Defect sealing | Early oral intake; Reduce stricture formation | Stent migration; Tissue ingrowth/overgrowth pain; Need of externaldrainage | ++ | + | ++ |
EID | Second intention closure | Early oral intake; Internal drainage; More effective in acute setting | Stricture | + | ++ | ++ |
Suturing system | Direct closure | True full-thickness closure; Single operator (Overstich®) | On healthy tissue; More difficult in tight endoluminal space and tangential suturing site | +++ | + | +++ |
EVT | Second intention closure | Continuous drainage; More effective in early stage | Limited to rectal/esophageal site; Need of de-functioning stoma; Less effective if late diagnosis | + | +++ | + |
Tissue sealant | Miscellaneous | Antibacterial (cyanoacrylate); Used in combination; No inflammatory reaction (Surgisis®) | On dry areas (fibrin glue); Inflammatory reaction (cyanoacrylate/fibrin glue) | + | ++ | + |
- Citation: Cereatti F, Grassia R, Drago A, Conti CB, Donatelli G. Endoscopic management of gastrointestinal leaks and fistulae: What option do we have? World J Gastroenterol 2020; 26(29): 4198-4217
- URL: https://www.wjgnet.com/1007-9327/full/v26/i29/4198.htm
- DOI: https://dx.doi.org/10.3748/wjg.v26.i29.4198