title: Endoscopic treatment of gastrointestinal fistulas using an over-the-scope clip (OTSC) device: case series from a tertiary referral center.
abstract: Gastrointestinal perforations and post-surgical fistulas are dreaded complications that dramatically increase morbidity and mortality. A new endoscopic over-the-scope clip (OTSC) system may be potentially useful for sealing visceral perforations in several clinical settings. We evaluated the advantages and clinical impact of the placement of OTSCs on the management of non-malignant gut leaks in 12 consecutive patients. OTSCs of 9.5 or 10.5 mm were used, according to the diameter of the defect within the wall. The indications for treatment were mainly related to post-surgical fistulas. Healing of the fistula was assessed by endoscopic or radiological means, and failed only once. No OTSC-related complications occurred. Endoscopic closure of perforations and post-surgical fistulas with the OTSC system is a simple and minimally invasive technique. This approach, when feasible, may be less expensive and more advantageous than a surgical approach.
authors.affiliation: Gastroenterology and Endoscopy Unit, S. Agostino Estense Civil Hospital, Modena, Italy. r.manta@libero.it
authors.forename: R
authors.initials: R
authors.lastname: Manta
authors.forename: M
authors.initials: M
authors.lastname: Manno
authors.forename: H
authors.initials: H
authors.lastname: Bertani
authors.forename: C
authors.initials: C
authors.lastname: Barbera
authors.forename: F
authors.initials: F
authors.lastname: Pigò
authors.forename: V
authors.initials: V
authors.lastname: Mirante
authors.forename: E
authors.initials: E
authors.lastname: Longinotti
authors.forename: G
authors.initials: G
authors.lastname: Bassotti
authors.forename: R
authors.initials: R
authors.lastname: Conigliaro
mesh_terms: D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D020776:Endoscopes, Gastrointestinal; D004937:Esophageal Fistula / Q000601:surgery*; D005260:Female; D005747:Gastric Fistula / Q000601:surgery*; D006801:Humans; D007412:Intestinal Fistula / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013525:Surgical Instruments; D016896:Treatment Outcome