The Over-The-Scope-Clip (OTSC) System is Effective in the Treatment of Chronic Esophagojejunal Anastomotic Leakage

Abstract

The OTSC system may represent a new therapeutic option in the management of postoperative esophagojejunal anastomotic leakage.

Anastomotic leakage after gastrointestinal surgery: Diagnosis and management

“…The efficacy of these procedures is limited by the size of the dehiscence (1 cm for glue and 2 cm for clips) [30,31]; • use of recently-introduced Ovesco ® ''wolf-trap'' OTS clips, has been described in several publications involving a variety of different localizations and causes of AL, some of which were very rare such as a leak from a esophago-jejunostomy [32]. The advantage of these clips is their wide purchase allowing closure of holes as large as 30 mm in diameter with a closing force of 8-9 Newtons, much more robust than classical hemostatic clips [32,33]. Their efficacy is less optimal in organized AL as compared with recent perforations or AL, because of retraction and inflammatory fibrosis.…”

Description of a new, endoscopic technique to remove the over-the-scope-clip in an ex vivo porcine model (with video)

“…[14][15][16][17][18][19][20][21][22][23][24][25] However, in none of these studies is there mention of clip removal. In most situations, clip placement is a life-saving action.…”

“…[11][12][13][14][15][16][17] In addition, the OTSC system has also been found useful to close fistulae and anastomotic leaks and to provide hemostasis. [18][19][20][21][22][23][24][25] However, a potential limitation of the OTSC system is that once it is deployed, it cannot be removed.…”

Nahtinsuffizienz intestinaler Anastomosen: Endoskopische und laparoskopische Therapieoptionen

“…nach endoskopischer Mukosa- oder Submukosadissektion, eine Rolle [35]. Bei Anastomoseninsuffizienzen sind diese sogenannten Over-the-Scope-Clips (OTSC) aufgrund der Gewebequalität und der Defektgröße in der Regel nicht geeignet [35,36,37]. Die Ergebnisse für die Stenttherapie nach Ösophagus- und Magenresektionen sind sehr variabel, erreichen aber Erfolgsquoten von bis zu 100%.…”