Innovative BougieCap and resection method developed in cooperation with Ovesco, randomized controlled study shows significant superiority of OTSC therapy over endoscopic standard techniques in recurrent ulcer bleeding
The Fusion of the 47th Conference of the German Society for Endoscopy and Imaging Procedures (DGE-BV) and “ENDOSKOPIE LIVE” took place in Berlin, Germany on April 06 – 08, 2017. Several workshops, talks, posters, videos and a symposium presented original research with Ovesco technology and procedures.
New products: Innovative BougieCap and additional working channel (AWC)
BM Walter and A Meining, InExEn, University hospital Ulm, Germany, presented a conically tapering transparent BougieCap for therapy of gastrointestinal stenosis, which allows that the endoscope itself is used for dilatation of the stenosis. The endoscopist keeps direct and immediate visual control over progress and local effect of the dilatation at all times of the procedure. Clinical application in post-surgical and radiogenic stenoses showed the handling of the BougieCap being easy and the therapeutic effect similar to that with standard dilatation techniques, but achieved in a shorter procedure time.
BM Walter and colleagues also presented the application of an additional external working channel (AWC), which can be fixed at the outer margin of a standard endoscope. This allows bimanual instrumentation and en-bloc resection of even large and complex polyps (EMR+ technique). The concept of EMR+ with AWC has so far been object of preclinical studies: lesions of up to 6 cm in diameter could be resected easily and fast without complications.
Dr. med. A. Schmidt receives DGE-BV award “best contribution upper GI-tract 2017” for RCT on OTSC vs standard therapy for recurrent peptic ulcer bleeding
A Schmidt and colleagues, University of Freiburg, presented the randomized controlled STING trial, which shows 84.4 % clinical success (= hemostasis and non-recurrence of bleeding for 7 days) in treatment of recurrent ulcer bleeding with OTSC vs 40.6 % with endoscopic standard therapy (p < 0.001).
E Wedi and colleagues, University of Goettingen, presented the FLETRock study, a multi-center study in 118 patients with upper gastrointestinal bleeding (Forrest Ia-IIb). All patients received an OTSC for first-line-therapy (ETO cohort). For comparison the predicted outcome according to the validated Rockall score was used. Treatment with the OTSC significantly reduced the re-bleeding rate in the middle- and high-risk group in comparison to the Rockall Score (4.9 vs 24.0 % in the middle-risk group and 21.4 vs 53.2 % in the high-risk group; p < 0.001). Also the mortality after re-bleeding could be reduced by OTSC therapy (1.7 vs 7.3 % in the middle-risk and 10.9 vs 27.9 % in the high-risk group; p = 0.121 and 0.011, respectively).
Verwendung einer neuartigen Bougierungskappe zur Therapie von gastrointestinalen Stenosen. Walter BM, Meining A, Ulm.
EMR+ mit AWC: Ein neues Verfahren zur Großflächenpolypektomie. Walter BM, Ulm; Wedi E, Göttingen; Meining A, Ulm.
Over-the-scope-clips (OTSC) versus endoskopische Standard-Therapie zur Behandlung der Rezidiv-Ulkus-Blutung – eine prospektive randomisierte multizentrische Studie (“STING”). Schmidt A, Ludwigsburg; Gölder S und Messmann H, Augsburg; Goetz M und Kratt T, Tübingen; Meining A und Birk M, Ulm; von Delius S, Munich; Albert J und Escher M, Stuttgart; Lau J, Hong Kong; Hoffmann A, Wiesbaden; Wiest R, Bern; und Caca K, Ludwigsburg.
Multizentrische Evaluation der endoskopischen Erstlinientherapie der oberen gastrointestinalen Blutung mit dem Over-The-Scope-Clip (OTSC) – FLETRock Study. Wedi E, Göttingen; Hochberger J, Berlin; Fischer A, Freiburg; Jung C, Göttingen; Richter-Schrag HJ, Freiburg.