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Journal of Gastrointestinal Surgery

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01-12-2016 | Original Article

The Clinical Utility of Over-the-Scope Clip for the Treatment of Gastrointestinal Defects

Authors: Ido Mizrahi, Rana Eltawil, Nadav Haim, Sami A. Chadi, Bo Shen, Tolga Erim, Giovanna DaSilva, Steven D. Wexner

Published in: Journal of Gastrointestinal Surgery | Issue 12/2016

Abstract

Background

The over-the-scope clip (OTSC) is a novel endoscopic tool that enables non-surgical management of gastrointestinal (GI) defects. The aim of this study was to report our experience with OTSC for patients with GI defects.

Methods

A prospectively maintained IRB-approved institutional database was queried for all patients treated with OTSC from 2012 to 2015. Primary outcome was the clinical success of the OTSC for the individual indication. Secondary outcome was the number of additional procedures needed following OTSC.

Results

Fifty-one patients were treated with OTSC: upper GI (UGI) 30 and lower GI (LGI) 21. GI leak (n = 24; UGI = 12, LGI = 12) and fistulae (n = 17; UGI = 8, LGI = 9) were the most common indications. Overall success rate for the treatment of leaks was 59 % [UGI 66 % vs. LGI 33 % (p = 0.1)]. A lower success rate (35 %) was noted for fistulae [UGI 62 % vs. LGI 0 % (p = 0.001)]. Success rates for UGI perforation, bleeding, and stent anchoring indications were 75, 75, and 50 %, respectively. Additional endoscopic or surgical interventions following OTSC were indicated in 68.6 % of the patients.

Conclusions

OTSC appears to have additional value in treating UGI defects. However, lower success rates for LGI defects were noted, specifically for fistulae. Most patients require an additional endoscopic or surgical procedure after one OTSC application.

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Title: The Clinical Utility of Over-the-Scope Clip for the Treatment of Gastrointestinal Defects
Authors: Ido Mizrahi
Rana Eltawil
Nadav Haim
Sami A. Chadi
Bo Shen
Tolga Erim
Giovanna DaSilva
Steven D. Wexner
Publication date: 01-12-2016
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 12/2016
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-016-3282-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The Clinical Utility of Over-the-Scope Clip for the Treatment of Gastrointestinal Defects

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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