The Clinical Utility of Over-the-Scope Clip for the Treatment of Gastrointestinal Defects.
The over-the-scope clip (OTSC) is a novel endoscopic tool that enables non-surgical management of gastrointestinal (GI) defects. The aim of this study was to report our experience with OTSC for patients with GI defects.



A prospectively maintained IRB-approved institutional database was queried for all patients treated with OTSC from 2012 to 2015. Primary outcome was the clinical success of the OTSC for the individual indication. Secondary outcome was the number of additional procedures needed following OTSC.



Fifty-one patients were treated with OTSC: upper GI (UGI) 30 and lower GI (LGI) 21. GI leak (n = 24; UGI = 12, LGI = 12) and fistulae (n = 17; UGI = 8, LGI = 9) were the most common indications. Overall success rate for the treatment of leaks was 59 % [UGI 66 % vs. LGI 33 % (p = 0.1)]. A lower success rate (35 %) was noted for fistulae [UGI 62 % vs. LGI 0 % (p = 0.001)]. Success rates for UGI perforation, bleeding, and stent anchoring indications were 75, 75, and 50 %, respectively. Additional endoscopic or surgical interventions following OTSC were indicated in 68.6 % of the patients.



OTSC appears to have additional value in treating UGI defects. However, lower success rates for LGI defects were noted, specifically for fistulae. Most patients require an additional endoscopic or surgical procedure after one OTSC application.
Digestive Disease Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
Ido
I
Mizrahi
Digestive Disease Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
Rana
R
Eltawil
Digestive Disease Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
Nadav
N
Haim
Digestive Disease Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
Sami A
SA
Chadi
Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA.
Bo
B
Shen
Digestive Disease Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA. erimt@ccf.org.
Tolga
0000-0001-9771-8585
T
Erim
Digestive Disease Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
Giovanna
G
DaSilva
Digestive Disease Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
Steven D
SD
Wexner
D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000601:surgery*; D016154:Digestive System Fistula / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D017211:Treatment Failure
Endoscopy; Gastrointestinal defects; Over-the-scope clip; Surgery
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