Efficacy of the Over-the-Scope Clip System for Treatment of Gastrointestinal Fistulas, Leaks, and Perforations: A Korean Multi-Center Study
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Background/Aims: Currently, a new over-the-scope clip (OTSC) system has been introduced. This system has been used forgastrointestinal perforations and fistulas in other countries. The aim of our study is to examine the therapeutic success rate ofendoscopic treatment using the OTSC system in Korea. Methods: This was a multicenter prospective study. A total of seven endoscopists at seven centers performed this procedure. Results: A total of 19 patients were included, with gastrointestinal leakages from anastomosis sites, fistulas, or esophageal perforationsdue to Boerhaave’s syndrome. Among these, there were three gastrojejunostomy sites, three esophagojejunostomy sites, fouresophagogastrostomy sites, one esophagocolonostomy site, one jejuno-jejunal site, two endoscopic full thickness resection site closures,one Boerhaave’s syndrome, two esophago-bronchial fistulas, one gastrocolonic fistula, and one colonopseudocyst fistula. The size of theleakage ranged from 5 to 30 mm. The median procedure time was 16 min. All cases were technically successful. Complete closure ofthe leak was achieved in 14 of 19 patients using OTSC alone. Conclusions: The OTSC system is a safe and effective method for the management of gastrointestinal leakage, especially in cases ofanastomotic leakage after surgery.
Abstract
Background/Aims: Currently, a new over-the-scope clip (OTSC) system has been introduced. This system has been used forgastrointestinal perforations and fistulas in other countries. The aim of our study is to examine the therapeutic success rate ofendoscopic treatment using the OTSC system in Korea. Methods: This was a multicenter prospective study. A total of seven endoscopists at seven centers performed this procedure. Results: A total of 19 patients were included, with gastrointestinal leakages from anastomosis sites, fistulas, or esophageal perforationsdue to Boerhaave’s syndrome. Among these, there were three gastrojejunostomy sites, three esophagojejunostomy sites, fouresophagogastrostomy sites, one esophagocolonostomy site, one jejuno-jejunal site, two endoscopic full thickness resection site closures,one Boerhaave’s syndrome, two esophago-bronchial fistulas, one gastrocolonic fistula, and one colonopseudocyst fistula. The size of theleakage ranged from 5 to 30 mm. The median procedure time was 16 min. All cases were technically successful. Complete closure ofthe leak was achieved in 14 of 19 patients using OTSC alone. Conclusions: The OTSC system is a safe and effective method for the management of gastrointestinal leakage, especially in cases ofanastomotic leakage after surgery.
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