Publicação

Endoscopic management of digestive leaks with the Over-The-Scope Clip: A retrospective study

Detalhes bibliográficos
Resumo:	Introduction: The Over-The-Scope Clip (OTSC®) is a device with promising applications in endoscopic closure of perforations/dehiscence/ﬁstulas, endoscopic hemostasis and NOTES. Aims: To evaluate the clinical effectiveness and safety of OTSC. Methods: Between September 2011 and September 2013, 6 consecutive patients underwent OTSC placement by two experienced endoscopists. In three patients OTSC was used in the closure of surgical dehiscences, both in upper digestive tract (after esofagojejunostomy and gastric sleeve) and in lower digestive tract (blind loop dehiscence after colorectal anastomosis). Two patients had esophageal ﬁstulas with several weeks duration (one to the bronchial tree and other to the pleura). Furthermore, OTSC was used to close an iatrogenic perforation following colonic polipectomy. Results: All procedures experienced technically immediate success and there were no complications related to the placement of the OTSC (1 clip). It was well tolerated and patients were hospitalized on average 15 days (5-53 days). However, during follow-up (mean = 12.4; 5-22 months) permanent closure of chronic esophageal-bronchial ﬁstula could not be achieved in one patient. Conclusion: In our experience, OTSC shows efﬁcacy in solving gastrointestinal leaks.
Autores principais:	Correia,Tito
Outros Autores:	Amaro,Pedro; Oliveira,Ana; Fernandes,Alexandra; Branquinho,Diogo; Nunes,Ana; Portela,Francisco; Soﬁa,Carlos
Assunto:	Over-The-Scope clip Gastrointestinal leaks Fistula Perforation
Ano:	2014
País:	Portugal
Tipo de documento:	artigo
Tipo de acesso:	acesso aberto
Instituição associada:	Fundação para a Ciência e Tecnologia
Idioma:	inglês
Origem:	SciELO Portugal

Descrição
Resumo:	Introduction: The Over-The-Scope Clip (OTSC®) is a device with promising applications in endoscopic closure of perforations/dehiscence/ﬁstulas, endoscopic hemostasis and NOTES. Aims: To evaluate the clinical effectiveness and safety of OTSC. Methods: Between September 2011 and September 2013, 6 consecutive patients underwent OTSC placement by two experienced endoscopists. In three patients OTSC was used in the closure of surgical dehiscences, both in upper digestive tract (after esofagojejunostomy and gastric sleeve) and in lower digestive tract (blind loop dehiscence after colorectal anastomosis). Two patients had esophageal ﬁstulas with several weeks duration (one to the bronchial tree and other to the pleura). Furthermore, OTSC was used to close an iatrogenic perforation following colonic polipectomy. Results: All procedures experienced technically immediate success and there were no complications related to the placement of the OTSC (1 clip). It was well tolerated and patients were hospitalized on average 15 days (5-53 days). However, during follow-up (mean = 12.4; 5-22 months) permanent closure of chronic esophageal-bronchial ﬁstula could not be achieved in one patient. Conclusion: In our experience, OTSC shows efﬁcacy in solving gastrointestinal leaks.