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Erschienen in: European Surgery 4/2014

01.08.2014 | Original Article

Over-the-scope endoclipping for foregut leaks and perforations

verfasst von: A. Aiolfi, D. Bona, E. Asti, S. Siboni, L. Pogliani, Prof. L. Bonavina

Erschienen in: European Surgery | Ausgabe 4/2014

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Summary

Background

Foregut leaks and perforations continue to account for high morbidity and mortality rates. Novel endoscopic techniques have recently changed the approach to the management of these complications. The purpose of this study was to evaluate the efficacy and safety of the Over-The-Scope Clipping system (OTSC) in a consecutive series of patients presenting with foregut leaks and perforations.

Patients and methods

We retrospectively reviewed the charts of seven consecutive patients treated between November 2010 and December 2013 in our tertiary care hospital. A parallel review of the literature was made including only patients treated with OTSC after upper gastrointestinal surgery.

Results

The median time between surgery and OTSC clipping was 18.4 days (range 7–53), and the median size of the defect was 6 mm (range 2–10). The overall OTSC success rate was 85.7 %. In 6 patients, 3 of whom had a chronic leak, the OTSC was successfully used as first-line treatment. The literature review showed that the overall success rate of the OTSC procedure was 66.7 % in esophageal defects and 80 % in gastric defects.

Conclusions

The OTSC system is a simple and safe method for the management of postoperative foregut leaks and perforations, resulting in complete and durable closure of small (< 1 cm) visceral defects. Use of the OTSC system, along with drainage of perivisceral collections, may represent a safe alternative to stents in selected patients.
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Metadaten
Titel
Over-the-scope endoclipping for foregut leaks and perforations
verfasst von
A. Aiolfi
D. Bona
E. Asti
S. Siboni
L. Pogliani
Prof. L. Bonavina
Publikationsdatum
01.08.2014
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 4/2014
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-014-0277-5

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