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Kobara H and colleagues, Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan performed a retrospective study examining 58 consecutive patients undergoing OTSC placement for gastrointestinal defect closure in 5 medical centers.
The overall rates of technical success, clinical success, complications and procedure time were analysed as major outcomes. Subsequently, 56 patients, excluding 2 cases that used the Anchor device, were divided into two groups: 14 cases of simple suction (SS-group) and 42 cases using the OTSC Twin Grasper (TG-group). Secondary evaluation was performed to clarify the predictors of OTSC success.
Overall clinical outcomes demonstrated efficacy and safety of the OTSC System and were as follows: technical success rate (TSR) 89.7 %, clinical success rate (CSR) 84.5 %, complications 1.8 %, and median procedure time 8 minutes (range 1-36 min).
Significant differences were observed between the two groups in terms of the mean procedure time (5.9 min vs 14.1 min). The clinical success rate of the SS- and TG-groups among cases with a maximum defect size ≤ 10 mm and immediate or acute refractory bleeding was 100 %, which suggests that SS is a better method than TG in terms of time efficacy. The clinical success rate in the SS-group (78.6 %), despite the technical success of the SS method (100 %), tended to decrease due to delayed leakage compared to that in the TG group (TSR 88.1 %, CSR 88.1 %), indicating that the OTSC Twin Grasper may be desirable for leaks and fistulae with defects of the entire layer.
The authors concluded, that the OTSC System is a safe and effective therapeutic option for gastrointestinal defects. Individualized selection of the suction method based on particular clinical conditions may contribute to the improvement of OTSC success.
Outcomes of gastrointestinal defect closure with an over-the-scope clip system in a multicenter experience: An analysis of a successful suction method
Kobara H, Mori H, Fujihara S, Nishiyama N, Chiyo T, Yamada T, Fujiwara M, Okano K, Suzuki Y, Murota M, Ikeda Y, Oryu M, AboEllail A, Masaki T (2017)
World J Gastroenterol 2017 March 7; 23(9): 1645-1656