RESUMO
Esophagectomy is a critical surgical procedure for managing various esophageal disorders, including malignancies, strictures, and reflux disease. Nonetheless, it is associated with significant postoperative complications, with anastomotic leak being a major concern. An anastomotic leak is defined as an unintended communication failure between the proximal esophageal segment and the conduit after surgery. This review explores evolving strategies for managing anastomotic leaks after esophagectomy, including factors contributing to leaks, such as patient-related, surgical, and perioperative factors. Diagnostic advancements, encompassing clinical evaluation, radiological imaging, and endoscopy, enable rapid and accurate detection, which is crucial for timely intervention. Management approaches have evolved beyond surgical revisions and now include conservative measures, antibiotics, and endoscopic therapies, particularly for high-risk surgical cases. Novel approaches, such as endoscopic stents, tissue sealants, and regenerative therapies, hold promise in revolutionizing treatment and outcomes. Prevention strategies, encompassing patient optimization, surgical techniques, and perioperative care, are key in minimizing leak occurrence. A multidisciplinary approach involving various specialists is essential for tailored treatments and optimized outcomes. In conclusion, anastomotic leaks post esophagectomy remain a significant challenge, and this review provides a comprehensive resource on evolving management strategies, from conservative measures to innovative techniques, assisting clinicians in decision-making for leak management.