OTSC has long been described in the scientific literature as a highly effective device for the treatment of upper GI hemorrhage. Now a randomized-controlled trial at 9 academic referral centers (in Germany, Switzerland, and Hong Kong) has proven OTSC to be superior to standard methods. The trial, published by Dr. Arthur Schmidt, Ludwigsburg, Germany, enrolled 66 patients with recurrent bleeding and randomized them to receive either OTSC therapy or standard techniques (a combination of 2 methods from through the scope clipping, injection or electrical coagulation).
Persistent bleeding after per-protocol hemostasis was observed in 42.4% of patients in the standard therapy group and 6.0% in the OTSC group (P=.001). Further bleeding occurred in 57.6% in the standard therapy group and 15.2% in the OTSC group (absolute difference, 42.4%; 95% CI 21.6-63.2; P=.001).
Gastroenterology. 2018 May 24. pii: S0016-5085(18)34570-0. doi: 10.1053/j.gastro.2018.05.037. [Epub ahead of print]
Over the Scope Clips are More Effective Than Standard Endoscopic Therapy for Patients With Recurrent Bleeding of Peptic Ulcers.
Schmidt A1, Gölder S2, Goetz M3, Meining A4, Lau J5, von Delius S6, Escher M7, Hoffmann A8, Wiest R9, Messmann H2, Kratt T2, Walter B4, Bettinger D10, Caca K11.
1Department of Gastroenterology, Klinikum Ludwigsburg, Ludwigsburg, Germany; Department of Medicine II, Medical Center , Faculty of Medicine, University of Freiburg, Germany.
2Department of Gastroenterology, Klinikum Augsburg, Augsburg, Germany.
3Interdisciplinary Endoscopy, University of Tübingen, Tübingen, Germany.
4Department of Gastroenterology, University of Ulm, Ulm, Germany.
5Department of Surgery, University of Hong Kong.
6Department of Gastroenterology, Klinikum Rechts der Isar, TU München, München, Germany.
7Department of Gastroenterology, Robert Bosch Krankenhaus Stuttgart, Stuttgart, Germany.
8Department of Gastroenterology, Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany.
9Department of Gastroenterology, Inselspital Bern, Bern, Switzerland.
10Department of Medicine II, Medical Center , Faculty of Medicine, University of Freiburg, Germany; Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg.
11Department of Gastroenterology, Klinikum Ludwigsburg, Ludwigsburg, Germany.