title: Safety and efficacy of fistula closure by endoscopic suturing: a multi-center study.
abstract: Background and aim:Endoscopic closure of fistulas is desirable but remains a challenge, especially for gastrogastric fistulas. The aim of this study was to assess the success rate for the closure of gastrointestinal fistulas using an endoscopic suturing device.Patients and methods:Electronic records at three medical centers were reviewed to identify patients who underwent sutured fistula closure as recorded on a central database. Demographic details, clinical variables, and details of the endoscopic procedure were recorded.Results:A total of 56 patients (mean age 54 ± 12.7 years) underwent fistula closure. Gastrogastric fistulas were most common (n = 29; 51.8 %). Sixteen patients (28.6 %) had undergone previous failed attempts at closure. Immediate success was universal (n = 56; 100 %). Thirteen patients had persistent closure without any need for further therapies, while 17 underwent additional endoscopic procedures, with successful closure in 4 /17. Only one patient had abdominal pain requiring hospital admission.Conclusion:Sutured closure of fistulas in a single session is safe and can be expected, even in what are known to be challenging cases. Sequential closure for recurrences is sometimes successful in the longer term.
authors: Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
authors: Saurabh
authors: S
authors: Mukewar
authors: Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors: Nitin
authors: N
authors: Kumar
authors: GI Associates, Milwaukee, Wisconsin, USA.
authors: Marc
authors: M
authors: Catalano
authors: Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors: Christopher
authors: C
authors: Thompson
authors: Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors: Wasif
authors: W
authors: Abidi
authors: Department of Biostatistics, Mayo Clinic, Rochester, Minnesota, USA.
authors: William
authors: W
authors: Harmsen
authors: Department of Biostatistics, Mayo Clinic, Rochester, Minnesota, USA.
authors: Felicity
authors: F
authors: Enders
authors: Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
authors: Christopher
authors: C
authors: Gostout
mesh_terms: D000328:Adult; D000368:Aged; D017577:Cutaneous Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D018572:Disease-Free Survival; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005747:Gastric Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013536:Suture Techniques / Q000009:adverse effects