title: [Advances on endoscopic treatment of intestinal fistulas].
abstract: Intestinal fistulas are severe complications after abdominal surgical procedures. The endoscopic therapy makes it possible to close fistulas without surgical interventions. When patients achieved stabilization and had no signs of systemic sepsis or inflammation, these therapies could be conducted, which included endoscopic vacuum therapy, fibrin glue sealing, stents, fistula plug, suture, and Over The Scope Clip (OTSC). Various techniques may be combined. Endoscopy vacuum therapy could be applied to control systemic inflammation and prevent continuing septic contamination by active drainage. Endoscopic stent is placed over fistulas and gastrointestinal continuity is recovered. The glue sealing is applied for enterocutaneous fistulas, and endoscopy suture has the best results seen in fistulas <1 cm in diameter. Insertion of the fistula plug is used to facilitate fistula healing. The OTSC is effective to treat leaks with large defects. Endoscopic treatment could avoid reoperation and could be regarded as the first-line treatment for specific patients.
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: X W
authors.initials: XW
authors.lastname: Wu
authors.forename: J A
authors.initials: JA
authors.lastname: Ren
authors.forename: J S
authors.initials: JS
authors.lastname: Li
mesh_terms: D004724:Endoscopy; D015718:Fibrin Tissue Adhesive; D006801:Humans; D007412:Intestinal Fistula / Q000601:surgery*; D015607:Stents; D013525:Surgical Instruments; D013536:Suture Techniques
chemical_list: D015718:Fibrin Tissue Adhesive