title: Endoscopic "rescue" treatment for gastrointestinal perforations, anastomotic dehiscence and fistula.
abstract: Luminal perforations and anastomotic leaks of the gastrointestinal tract are life-threatening events with high morbidity and mortality. Early recognition and prompt therapy is essential for a favourable outcome. Surgery has long been considered the "gold standard" approach for these conditions; however it is associated with high re-intervention morbidity and mortality. The recent development of endoscopic techniques and devices to manage perforations, leaks and fistulae has made non-surgical treatment an attractive and reasonable alternative approach. Although endoscopic therapy is widely accepted, comparative data of the different techniques are still lacking. In this review we describe, benefits and limitations of the current options in the management of patients with perforations and leaks, in order to improve outcomes.
authors.affiliation: Gastroenterology and Digestive Endoscopy Division, Vita-Salute San Raffaele Univeristy, San Raffaele Scientific Institute, Milan, Italy. Electronic address: emadabi@yahoo.it.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Dabizzi
authors.affiliation: Gastroenterology and Digestive Endoscopy Unit, "G. Borea" Hospital, San Remo, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: De Ceglie
authors.affiliation: Division of Gastroenterology and Hepatology, University of Alabama, Birmingham, AL, USA.
authors.forename: Kondal R
authors.initials: KR
authors.lastname: Kyanam Kabir Baig
authors.affiliation: Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
authors.forename: Todd H
authors.initials: TH
authors.lastname: Baron
authors.affiliation: Gastroenterology and Digestive Endoscopy Unit, "G. Borea" Hospital, San Remo, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Conio
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic Jacksonville, Florida, USA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Wallace
mesh_terms: D000714:Anastomosis, Surgical; D016154:Digestive System Fistula / Q000175:diagnosis / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000601:surgery*; D054843:Negative-Pressure Wound Therapy; D015607:Stents; D013275:Stomach Rupture / Q000175:diagnosis / Q000601:surgery*; D013525:Surgical Instruments; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000601:surgery*