Endoscopic treatment of postsurgical colorectal anastomotic leak (with videos).

d p g l The treatment of rectal cancer has evolved in recent years, and several neoadjuvant chemotherapy and radiotherapy regimens have been combined with less-expensive surgical approaches. However, these techniques also involve postsurgical adverse events, namely, colorectal stricture, rectocutaneous fistula, and suture dehiscence.1,2 The frequency of hese adverse events varies among studies. Postsurgical rectal fistula and dehiscence are not unommon findings in low anterior resection performed to reat rectal cancer.1,2 The initial approach is usually conservative.2 The lesion can be cleaned and fibrin glue can be injected endoscopically.3,4 Hemoclips, over-the-scope lips (Ovesco), and endoloops can also be used to join the dges of the fistula or dehiscence. Finally, Polyflex-type Boston Scientific, Natick, Mass) plastic stents5,6 or coated metal stents are an additional option.7 Sponges have also proved successful in the treatment of rectal dehiscence.8-10 Biodegradable expandable polydioxanone stents (coated and uncoated) are a new therapeutic option11-14 that enables the repair of a fistula or dehiscence of the anastomosis, thus, in theory, facilitating scar formation.7 We eport our experience with biodegradable stents comined with other endoscopic approaches to repair posturgical fistula and dehiscence.