OTSC use in patients with refractory gastrointestinal diseases achieved an overall clinical success rate of 78 %, 85 % for bleeding, 85 % for perforation, 52 % for fistula, 66 % for anastomotic dehiscence, and 95 % for other conditions. Overall OTSC-associated complications were 1.7 %, severe OTSC-associated complications 0.59 %.
Kobara H et al., Departments of Gastroenterology und Neurology, Faculty of Medicine, and Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Takamatsu, Japan, published a meta-analysis clarifying the current status and limitations of OTSC according to different indications of GI refractory disease, including refractory bleeding, perforation, fistula, and anastomotic dehiscence. An extensive literature search identified studies reporting on 10 or more cases, in which the OTSC System was applied. A total of 1517 cases described in 30 articles were retrieved. The clinical success rates and complications were calculated overall and for each indication.
The average clinical success rate was 78.3 % (n = 1517) overall, 84.6 % for hemorrhage (n = 559), 84.6 % (n = 351) for perforation, 51.5 % (n = 388) for fistula, 66 % (n = 97) for anastomotic dehiscence, and 95.1 % (n = 122) for other conditions, respectively. The authors rated these results, despite the lower performance of the OTSC System for fistula, as more than satisfactory when considering that there are no other effective endoscopic methods currently available and these refractory conditions hitherto required surgical interventions. With respect to safety, the overall OTSC-related complication rate was 1.7 % (26/1517 cases), the incidence rate of severe complications that required surgery was 0.59 % (9/1517 cases).
The authors concluded that the OTSC system serves as a safe and effective device for GI refractory diseases, which hitherto required surgical interventions.
Over-the-scope clip system: A review of 1517 cases over 9 years.
Kobara H, Mori H, Nishiyama N, Fujihara S, Okano K, Suzuki Y, Masaki T.
J Gastroenterol Hepatol 2018 Aug 2 doi:10.1111/jgh.14402