100 % long-term success with OTSC in acute GI defects, 73 % in chronic defects

Gianfranco G. et al., Interventional Endoscopy Unit, Hospital Privé des Peupliers, Paris, France, presented a retrospective study from a prospectively-maintained database evaluating immediate and long-term success rates of OTSC deployment in acute and chronic gastrointestinal pathologies.

Between 01/2012 and 12/2015 a total of 51 OTSCs were delivered in 45 patients (35 female, average age 56 years, range 24-90) due to GI defects resulting from a diagnostic or interventional endoscopic procedure (acute setting group; n=15) or due to fistula following abdominal surgery (chronic setting group; n=30). All procedures were carried out in a private endoscopic service.

Technical success was always achieved in the acute setting group with an excellent clip adherence and a clinical long-term success rate of 100 % (15/15, median follow-up 9 months, range 1-24 months).

Considering the chronic setting group (OTSC treatment after an average period of 146.6 days (range 5-880 days) after primary surgery), technical success was achieved in 50 % of patients (15/30).  Long-term clinical success in patients with succeeded primary fistula closure by OTSC was 73.3 % (11/15; mean follow-up 23 months, range 1-34 months). Two minor complications occurred. A total of three patients died due to causes not directly related to clip deployment.

The authors concluded that OTSC deployment is an effective and minimally-invasive procedure for GI defects in acute settings. It avoids emergency surgical repair and it allows, in most cases, completion of the primary endoscopic procedure. OTSC should be incorporated as an essential technique of today’s modern endoscopic armamentarium in the management of GI defects in acute settings. OTSCs were less effective in cases of chronic defects.

Closure of gastrointestinal defects with Ovesco clip: long-term results and clinical implications.
Donatelli G, Cereatti F, Dhumane P, Vergeau BM, Tuszynski T, Marie C, Dumont JL, Meduri B (2016)
Therap Adv Gastroenterol. 2016 Sep;9(5):713-21.