Endoscopic treatment of anastomotic leakage after upper gastrointestinal surgery: endoscopic self-expandable metallic stent or endoscopic vacuum therapy?

Anastomotic leakage is a serious complication following upper gastrointestinal (UGI) surgery, associated with high morbidity and mortality rates. Effective management strategies aim to close or cover the defect, contain the leak, and adequately drain the affected area. In recent years, endoscopic techniques have emerged as viable alternatives or adjuncts to surgical interventions. This review discusses two major endoscopic modalities - self-expandable metal stents (SEMS) and endoscopic vacuum therapy (EVT) - in anastomotic leaks after gastric and esophageal cancer surgery. By evaluating the efficacy, indications, and limitations of SEMS and EVT techniques, this article provides a comprehensive overview to assist clinicians in optimizing patient outcomes in UGI postoperative anastomotic leaks.