Esophageal anastomotic fistula (AF) is a frequent and severe complication of an esophagectomy due to esophageal or eso-gastric junction cancer, regardless of the selected surgical technique. AF is usually treated by endoscopic stent placement. Objectives: This study aims to examine the efficacy of stents in the treatment of AF, analyzing the healing period and the factors that contribute to its delay. Methods: We collected data from 55 patients who underwent stent implantation for AF, and analyzed multiple variables related to patient healing time and surgical technique with two primary endpoints: post-stenting hospital stay and the time of stent usage until fistula closure. The patients were divided into three groups based on the anastomosis type (eso-gastric anastomosis, eso-gastric cervical anastomosis and eso-jejunal anastomosis) and they were compared using the primary endpoints. Results: Our findings show the differences between the three groups, with a longer hospital stay for eso-gastric anastomosis, and an extended time of fistula closure in the case of eso-gastric cervical anastomosis. We also found a significant correlation between the size of the fistula and the hospital stay (R = 0.4, p < 0.01). Regarding patients’ risk factors, our results show an extended post-stenting hospital stay for those patients that underwent preoperative radiotherapy. Conclusions: Our results offer an extended view of the efficiency, hospitalization duration and healing time for esophageal anastomotic fistula, and reveal some of the factors that interfere with its resolution.

Type 2 diabetes mellitus is a complex condition with high prevalence in the global population, implying multiple complications for the entire organism. It is essential to understand its implications in the development and evolution of other pathologies in order to manage efficiently their complications thus decreasing overall mortality. A surgical pathology potentially associated with type 2 diabetes is acute mesenteric ischemia. Although it has a decreased prevalence in the global population, mesenteric infarction is related to an extremely high mortality rate due to its elusive clinical presentation and rapid progression. The difficult diagnosis emphasizes the need to make associations between acute mesenteric ischemia and other pathologies involved in its evolution, such as type 2 diabetes mellitus. This metabolic disease raises the risk of macro and microvascular complications, therefore disturbing the vascularization of the bowel. The purpose of this review is to describe how diabetes is particularly involved in all four types of mesenteric infarction by modulating different physiopathological mechanisms based on the process of atherosclerosis and other endothelial molecular processes.