Endoscopic repair of post-surgical gastrointestinal complications |
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Authors: | Raffaele Manta Luca Magno Rita Conigliaro Angelo Caruso Helga Bertani Mauro Manno Angelo Zullo Marzio Frazzoni Gabrio Bassotti Giuseppe Galloro |
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Affiliation: | 1. Gastroenterology and Endoscopy Unit, New S. Agostino Hospital, Modena, Italy;2. Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Unit of Surgical Digestive Endoscopy, University of Naples “Federico II”, Naples, Italy;3. Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy;4. Digestive Pathophysiology Unit, New S. Agostino Hospital, Modena, Italy;5. Gastroenterology and Digestive Endoscopy, “Nuovo Regina Margherita” Hospital, Rome, Italy |
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Abstract: | Complications following gastrointestinal surgery may require re-intervention, can lead to prolonged hospitalization, and significantly increase health costs. Some complications, such as anastomotic leakage, fistula, and stricture require a multidisciplinary approach. Therapeutic endoscopy may play a pivotal role in these conditions, allowing minimally invasive treatment. Different endoscopic approaches, including fibrin glue injection, endoclips, self-expanding stents, and endoscopic vacuum-assisted devices have been introduced for both anastomotic leakage and fistula treatment. Similarly endoscopic treatments, such as endoscopic dilation, incisional therapy, and self-expanding stents have been used for anastomotic strictures. All these techniques can be safely performed by skilled endoscopists, and may achieve a high technical success rate in both the upper and lower gastrointestinal tract. Here we will review the endoscopic management of post-surgical complications; these techniques should be considered as first-line approach in selected patients, allowing to avoid re-operation, reduce hospital stay, and decrease costs. |
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Keywords: | Endoscopic clips Endoscopic treatment Fistula Post-surgical complications Stenosis Stents |
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