Additional over-the-scope-clip closure can shorten endoscopic vacuum therapy for postoperative upper gastrointestinal leakage
Background and study aims Endoscopic vacuum therapy (EVT) has become the most effective therapeutic option for upper gastrointestinal leakage. Despite its efficiency, this treatment can necessitate a long hospitalization. The aim of this study was to evaluate whether additional use of an over-the-scope-clips (OTSC) closure after successful EVT can shorten leakage therapy. Patients and methods All patients treated with EVT for leakages in the upper gastrointestinal tract at our center from 2012 to 2022 were divided into two propensity matched cohorts (EVT+OTSC vs. EVT only). The EVT+OTSC patients received OSTC application at the end of successful EVT directly after removal of the last sponge. The primary endpoint was the time interval from leakage diagnosis until discharge. Secondary endpoints included EVT efficacy, complications, and nutritional status at discharge. Results A total of 84 matched patients were analyzed. EVT efficacy was 100% in both groups. The time interval from leakage until discharge was significantly shorter in the EVT+OTSC vs. EVT group (33 [19–48] vs. 46 days [29–77] P = 0.004). No patient in the EVT+OTSC group required additional procedures for leakage management, whereas five (12%) in the EVT group needed additional stent placement (P = 0.021). More patients could be discharged on sufficient oral nutrition in the EVT+OTSC group (98% vs. 60%; P < 0.001). Conclusions The addition of OTSCs after successful EVT is safe and has the potential to shorten leakage therapy, enabling earlier discharge along with better functional outcomes.
- Location
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Deutsche Nationalbibliothek Frankfurt am Main
- Extent
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Online-Ressource
- Language
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Englisch
- Bibliographic citation
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Additional over-the-scope-clip closure can shorten endoscopic vacuum therapy for postoperative upper gastrointestinal leakage ; volume:12 ; number:09 ; year:2024 ; pages:E1023-E1028
Endoscopy International Open ; 12, Heft 09 (2024), E1023-E1028
- Contributor
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Kollmann, Lars
Weich, Alexander
Gruber, Maximilian
Flemming, Sven
Meining, Alexander
Germer, Christoph-Thomas
Lock, Johann Friso
Seyfried, Florian
Brand, Markus
Reimer, Stanislaus
- DOI
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10.1055/a-2387-2054
- URN
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urn:nbn:de:101:1-2411141016387.042114803809
- Rights
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Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
- Last update
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07.04.2024, 9:04 AM CEST
Data provider
Deutsche Nationalbibliothek. If you have any questions about the object, please contact the data provider.
Associated
- Kollmann, Lars
- Weich, Alexander
- Gruber, Maximilian
- Flemming, Sven
- Meining, Alexander
- Germer, Christoph-Thomas
- Lock, Johann Friso
- Seyfried, Florian
- Brand, Markus
- Reimer, Stanislaus
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Endoscopic closure of duodenocolic fistula by using an over-the-scope clip
Successful closure of an esophagopericardial fistula with an over-the-scope clip
Over-the-scope clip
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Endoscopic vacuum-assisted closure therapy for leakage of the lower gastrointestinal tract: multicenter experiences
Vacuum-assisted closure therapy in ureteroileal anastomotic leakage after surgical therapy of bladder cancer
Large iatrogenic sigmoid colon perforation treated with endoloop-assisted clip closure and over-the-scope clip: a case report
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Closure of Lateral Duodenal Wall Perforation using Over-the-Scope Clip
Closure of an ischemic duodenal fistula with an over-the-scope clip
Over-the-scope clip (OTSC) closure of a gastrobronchial fistula after esophagectomy
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Endoscopic closure of duodenocolic fistula by using an over-the-scope clip
Successful closure of an esophagopericardial fistula with an over-the-scope clip
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Endoscopic vacuum-assisted closure therapy for leakage of the lower gastrointestinal tract: multicenter experiences
Vacuum-assisted closure therapy in ureteroileal anastomotic leakage after surgical therapy of bladder cancer
Large iatrogenic sigmoid colon perforation treated with endoloop-assisted clip closure and over-the-scope clip: a case report