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GE-Portuguese Journal of Gastroenterology

Print version ISSN 2341-4545

Abstract

CORREIA, Tito et al. Endoscopic management of digestive leaks with the Over-The-Scope Clip: A retrospective study. GE Port J Gastroenterol [online]. 2014, vol.21, n.5, pp.184-191. ISSN 2341-4545.  http://dx.doi.org/10.1016/j.jpg.2014.03.003.

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.

Keywords : Over-The-Scope clip; Gastrointestinal leaks; Fistula; Perforation.

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