Mangiafico S et al., Azienda Ospedaliero, University of Modena, Italy, presented at the 25th UEG week (October 28 – November 1, 2017, Barcelona) data from 9 Italian tertiary referral centers comprising a large series of patients with non-variceal upper and lower gastrointestinal bleeding lesions in whom OTSC was used as first-line endoscopic treatment.
Over a period of three years (01/2014 – 01/2017), data on 201 consecutive patients (mean age 68 years, range 28-89 years), who underwent emergency endoscopy for severe acute nonvariceal gastrointestinal bleeding and were treated with OTSC as primary first-line therapy, was prospectively collected and analyzed.
106/201 patients were treated with the a version of the OTSC system while in 95/201 patients the t clip was preferred. Indications for OTSC treatment included duodeno-jejunal ulcer Forrest 1a (n=29) and Forrest 1 b (n=35), gastric ulcer Forrest 1a (n=19) and Forrest 1b (n=28), Mallory Weiss (n=19), Dieulafoy’s lesion (n=9), post gastric- ESD bleeding (n=14), post EMR bleeding (n=15), post ESD bleeding (n=12), traumatic rectal ulcer (n=2), colonic diverticulum (n=4), and surgical anastomosis bleeding (n=15).
Technical success was achieved in all cases (100%). Primary hemostasis was achieved in 193/201 patients (96%). In the remaining 8 patients hemostasis was obtained with radiological vascular embolization (n=5) or surgery (n=3).
Early re-bleeding (within the first 24 hours) occurred in 9/201 patients (4%) and it was treated with epinephrine injection with or without use of through the scope clips or radiological vascular embolization. No late re-bleeding was observed in the series.
The authors concluded that the use of OTSC as first-line therapy in acute high-risk gastrointestinal bleeding is safe and highly effective.
High efficacy of OTSC as first-line endoscopic treatment in patients with gastrointestinal bleeding: an italian multicentric experience in a large cohort of patients.
Mangiafico S, Russo S, Lupo M, Caruso A, Grande G, Zito F, Bertani H, Conigliaro R, Pisani A, Germaná B, Galloro G, Pasquale L, Mangiavillano B, Bassotti G, Mutignani M, Manta R (2017)