title: The Over-The-Scope Clip (OTSC) for the treatment of gastrointestinal bleeding, perforations, and fistulas.
abstract: BACKGROUND
  The Over-The-Scope Clip (OTSC(®)) enables the treatment of patients with gastrointestinal complications such as bleeding, perforations, and fistulas. The aim of this retrospective study was to analyze the therapeutic results of the performed treatments.
  
  
  METHODS
  Since April 2006, 50 patients have been treated for different indications with the OTSC clip in our department. Besides hemostasis (n = 27) in the colon and the upper GI tract, the clip has been used for closure of esophageal and gastric perforations and adaptation of covered and free perforations after colonoscopy (n = 11). Furthermore, the OTSC has been used to close fistulas (n = 8) and for preoperative marking (n = 4).
  
  
  RESULTS
  The primary treatment was successful in all cases. There were two secondary bleedings that required endoscopic interventions. Closure of iatrogenic perforations of the upper and lower GI tract was successful in all cases. A permanent closure of fistulas could not be achieved in all cases with the OTSC clip.
  
  
  CONCLUSIONS
  The OTSC clip is effective and safe for complicated bleeding and closure of perforations of the gastrointestinal tract. Nevertheless, sufficient closure of chronic fistulas with the OTSC still remains an unsolved problem.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Tübingen, Hoppe-Seyler-Straße 3, 72072 Tübingen, Germany. akirschniak@aol.com
authors.forename: Andreas
authors.initials: A
authors.lastname: Kirschniak
authors.forename: Natalie
authors.initials: N
authors.lastname: Subotova
authors.forename: Derek
authors.initials: D
authors.lastname: Zieker
authors.forename: Alfred
authors.initials: A
authors.lastname: Königsrainer
authors.forename: Thomas
authors.initials: T
authors.lastname: Kratt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D057918:Fiducial Markers; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D007412:Intestinal Fistula / Q000601:surgery*; D007416:Intestinal Perforation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012006:Rectovaginal Fistula / Q000601:surgery; D012189:Retrospective Studies; D013525:Surgical Instruments; D058106:Wound Closure Techniques / Q000295:instrumentation*; D055815:Young Adult