Endoscopic and surgical management of leakage and mediastinitis after esophageal surgery

Due to the specialisation of esophageal surgery a significant reduction of post-surgical mortality was possible during the last few decades. Nevertheless a high complication rate of about 30% remains even in the hands of experienced surgeons. Anastomotic leakage has an incidence between 5 and 30% leading to serious postoperative morbidity. With a broad range of conservative and endoscopic therapeutic methods there is encouraging progress in shortening the time to closure of the leakage and reducing the risk of severe systemic complications such as sepsis or malnutrition. If conservative therapy fails, re-surgery remains as an ultima-ratio option.