Liječnički vjesnik, Vol. 138 No. 3-4, 2016.
Professional paper
THE OVER-THE-SCOPE-CLIP FOR THE TREATMENT OF THE DIGESTIVE TUBE LEAKS AND TEARS: A CASE-SERIES
Hrvoje Iveković
Jadranka Brljak
Branko Bilić
Pave Markoš
Roland Pulanić
Rajko Ostojić
Nadan Rustemović
Abstract
Digestive tube damages represent a therapeutic challenge for the gastrointestinal endoscopists. Recenty, a novel device – the-over-the-scope clip (OTSC) – has been introduced for non-surgical treatment of gastrointestinal perforations, fistula, anastomotic leaks and refractory gastrointestinal bleeds. This study aimed to evaluate the therapeutic efficacy of OTSC in our case series. A total of nine patients were included (six males, medain age 72 years, range 58-86). The indications were upper gastrointestinal bleeding (refractory to standard endoscopic treatment: five patients, a vessel with a large caliber: one patient), fistula in two patients, and iatrogenic perforation of the sigmoid colon in one patient. Atraumatic and traumatic versions of OTSCs with twin graspers were used. All of the patients were treated with only one OTSC, and none of the patients required additional endoscopic treatment. The OTSC procedure had 100% technical success. In a subgroup of patients with perforation and fistulae, the clinical success was 67%, whereas in those with the bleedings it was 50%. The median follow-up was 34 days (range: 3-452). OTSC is a safe and effective device for closure of perforations and leaks. However therapeutic efficacy was subopimal in patients with the upper gastrointestinal bleedings possibly due to the application of the sharp-teeth OTSC.
Keywords
Endoscopy, gastrointestinal – instrumentation, methods; Gastrointestinal hemorrhage – surgery; Hemostasis, endoscopic – instrumentation, methods; Fistula – surgery; Intestinal perforation – surgery; Anastomotic leak – surgery; Surgical instruments; Treatment outcome
Hrčak ID:
172841
URI
Publication date:
3.5.2016.
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