Closure of gastrointestinal defects with Ovesco clip: long-term results and clinical implications

Donatelli, Gianfranco; Cereatti, Fabrizio; Dhumane, Parag; Vergeau, Bertrand Marie; Tuszynski, Thierry; Marie, Christian de Sainte; Dumont, Jean-Loup; Meduri, Bruno

doi:10.1177/1756283x16652325

Cited by 39 publications

(21 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Among them, PubMed searches including studies with 10 or more cases of describing experience with the OTSC system, using “Over‐The‐Scope Clip” and “endoscopic closure” as key terms, lead to 30 literature references. The clinical results are summarized in Table …”

Section: Overall Clinical Outcomes Of the Over‐the‐scope Clip Systemmentioning

confidence: 99%

Over‐the‐scope clip system: A review of 1517 cases over 9 years

Kobara

Mori

Nishiyama

et al. 2018

J of Gastro and Hepatol

155

137

View full text Add to dashboard Cite

Rescue therapy for gastrointestinal (GI) refractory bleeding, perforation, and fistula has traditionally required surgical interventions owing to the limited performance of conventional endoscopic instruments and techniques. An innovative clipping system, the over-the-scope clip (OTSC), may play an important role in rescue therapy. This innovative device is proposed as the final option in endoscopic treatment. The device presents several advantages including having a powerful sewing force for closure of GI defects using a simple mechanism and also having an innovative feature, whereby a large defect and fistula can be sealed using accessory forceps. Consequently, it is able to provide outstanding clinical effects for rescue therapy. This review clarifies the current status and limitations of OTSC according to different indications of GI refractory disease, including refractory bleeding, perforation, fistula, and anastomotic dehiscence. An extensive literature search identified studies reported 10 or more cases in which the OTSC system was applied. A total of 1517 cases described in 30 articles between 2010 and 2018 were retrieved. The clinical success rates and complications were calculated overall and for each indication. The average clinical success rate was 78% (n = 1517) overall, 85% for bleeding (n = 559), 85% (n = 351) for perforation, 52% (n = 388) for fistula, 66% (n = 97) for anastomotic dehiscence, and 95% (n = 122) for other conditions, respectively. The overall and severe OTSC-associated complications were 1.7% (n = 23) and 0.59% (n = 9), respectively. This review concludes that the OTSC system may serve as a safe and productive device for GI refractory diseases, albeit with limited success for fistula.

show abstract

Section: Overall Clinical Outcomes Of the Over‐the‐scope Clip Systemmentioning

confidence: 99%

Over‐the‐scope clip system: A review of 1517 cases over 9 years

Kobara

Mori

Nishiyama

et al. 2018

J of Gastro and Hepatol

155

137

View full text Add to dashboard Cite

show abstract

“…OTSCs differ from traditional through-the-scope clips in several characteristics, namely higher compression force, larger diameter and grasping accessories that allow the closure of wall defects of up to 30 mm, including the muscle layer[ 42 - 44 ]. They have been successfully used and validated in literature in different settings, i.e ., haemostasis in acute GI bleeding, closure of GI perforations, leaks and fistulas or as anchor to prevent stent migration[ 45 ]. While clinical success is nearly 100% for haemostasis, it decreases to 40%-75% for GI defect closure, with best outcomes in acute perforations, which have fresh edges with less fibrosis[ 44 , 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal tract injuries after thermal ablative therapies for hepatocellular carcinoma: A case report and review of the literature

Rogger

Michielan

Sferrazza

et al. 2020

WJG

View full text Add to dashboard Cite

BACKGROUND Radiofrequency ablation (RFA) and microwave ablation (MWA) represent the standard of care for patients with early hepatocellular carcinoma (HCC) who are unfit for surgery. The incidence of reported adverse events is low, ranging from 2.4% to 13.1% for RFA and from 2.6% to 7.5% for MWA. Gastrointestinal tract (GIT) injury is even more infrequent (0.11%), but usually requires surgery with an unfavourable prognosis. Due to its low incidence and the retrospective nature of the studies, the literature reporting this feared complication is heterogeneous and in many cases lacks information on tumour characteristics, comorbidities and treatment approaches. CASE SUMMARY A 77-year-old man who had undergone extended right hepatectomy for HCC was diagnosed with early disease recurrence with a small nodule compatible with HCC in the Sg4b segment of the liver with a subcapsular location. He was treated with percutaneous RFA and a few week later he was urgently admitted to the Surgery ward for abdominal pain and fever. A subcutaneous abscess was diagnosed and treated by percutaneous drainage. A fistulous tract was then documented by the passage of contrast material from the gastric antrum to the abdominal wall. The oesophagogastroduodenoscopy confirmed a circular wall defect at the lesser curvature of gastric antrum, leading directly to the purulent abdominal collection. An over-the-scope clip (OTSC) was used to successfully close the defect CONCLUSION This is the first reported case of RFA-related GIT injury to have been successfully treated with an OTSC, which highlights the role of this endoscopic treatment for the management of this complication.

show abstract

“…A long indwelling time of OTS reflects its correct deployment over a suitable tissue and translates into a higher long-term clinical success. Donatelli et al[ 17 ] reported OTS clip outcome in a retrospective study comprising 45 patients, who presented both iatrogenic acute perforation (15 pts) as well as post-surgical leak and fistula (30 pts). In the latter group OTS clips were used as a rescue therapy after previous endoscopic treatments.…”

Section: Endoclipsmentioning

confidence: 99%

Endoscopic management of gastrointestinal leaks and fistulae: What option do we have?

Cereatti

Grassia

Drago

et al. 2020

WJG

Self Cite

View full text Add to dashboard Cite

Gastrointestinal leaks and fistulae are serious, potentially life threatening conditions that may occur with a wide variety of clinical presentations. Leaks are mostly related to post-operative anastomotic defects and are responsible for an important share of surgical morbidity and mortality. Chronic leaks and long standing post-operative collections may evolve in a fistula between two epithelialized structures. Endoscopy has earned a pivotal role in the management of gastrointestinal defects both as first line and as rescue treatment. Endotherapy is a minimally invasive, effective approach with lower morbidity and mortality compared to revisional surgery. Clips and luminal stents are the pioneer of gastrointestinal (GI) defect endotherapy, whereas innovative endoscopic closure devices and techniques, such as endoscopic internal drainage, suturing system and vacuum therapy, has broadened the indications of endoscopy for the management of GI wall defect. Although several endoscopic options are currently used, a standardized evidence-based algorithm for management of GI defect is not available. Successful management of gastrointestinal leaks and fistulae requires a tailored and multidisciplinary approach based on clinical presentation, defect features (size, location and onset time), local expertise and the availability of devices. In this review, we analyze different endoscopic approaches, which we selected on the basis of the available literature and our own experience. Then, we evaluate the overall efficacy and procedural-specific strengths and weaknesses of each approach.

show abstract

Closure of gastrointestinal defects with Ovesco clip: long-term results and clinical implications

Cited by 39 publications

References 26 publications

Over‐the‐scope clip system: A review of 1517 cases over 9 years

Over‐the‐scope clip system: A review of 1517 cases over 9 years

Gastrointestinal tract injuries after thermal ablative therapies for hepatocellular carcinoma: A case report and review of the literature

Endoscopic management of gastrointestinal leaks and fistulae: What option do we have?

Contact Info

Product

Resources

About