Honegger C and colleagues, Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland, presented data on 262 OTSC placements in a total of 233 interventions. Since 2009, the placement of OTSC has been established at the University Hospital Zurich for the entire spectrum of indications. OTSC has become a device of daily practice. A retrospective study now presents data of all patients treated with the OTSC device at the institution, focussing on indications, anatomic site of OTSC deployment, complications, and immediate and 30-day success rates.
Patient age ranged from 14 to 93 years with a median of 61 years. 51.5 % were male. Immediate success of OTSC treatment was observed in 87.1 % of all sessions (203/233). The success rates per indication were as follows: spontaneous bleeding 84.8 % (28/33); iatrogenic bleeding 100 % (20/20); acute perforation 90.3 % (65/72); prophylaxis for perforation 100% (24/24); anastomotic leakage 61.1 % (11/18); fistulae 80.7 % (46/57); diameter reduction of the gastro-jejunal anastomosis 100% (6/6); and stent fixation 100% (3/3).
At 30-day follow-up, the overall success rate was 67.4% (157/233). The success rates per indication were as follows: spontaneous bleeding 69.7% (23/33); iatrogenic bleeding 90% (18/20); acute perforation 86.1% (62/72); prophylaxis for perforation 100% (24/24); anastomotic leakage 33.3% (6/18); fistulae 29.8% (17/57), diameter reduction of the gastro-jejunal anastomosis 83.3% (5/6); and stent fixation 66% (2/3).
The authors concluded that the treatment with an OTSC is safe and feasible in clinical routine, with high immediate success rates with sustained clinical success at 30-day follow-up.
Establishment of Over-The-Scope-Clips (OTSC) in daily endoscopic routine
Honegger C, Valli PV, Wiegand N, Bauerfeind P, Gubler C (2016)
United European Gastroenterol J. 2017 Mar;5(2):247-254.