Weiland Timo, Fehlker Marion, Gottwald Thomas, Schurr Marc O
novineon CRO, Tuebingen, Germany.
Minim Invasive Ther Allied Technol. 2012 Jul;21(4):249-58. doi: 10.3109/13645706.2012.694367. Epub 2012 Jun 14.
Conventional endoscopic treatment options for closure of gastrointestinal fistulae are impaired by several limitations and therefore yield high rates of recurrence. Aim of the study is the evaluation of the primary-technical and secondary-clinical success rates in closure of gastrointestinal fistulae by means of the OTSC System.
DESIGN/METHODS: The database Medline was systematically searched for primary research on the evaluation of the OTSC System in closure of gastrointestinal fistulae. Appraisal of studies for inclusion and data extraction were performed independently by two reviewers using an a priori determined data extraction grid.
A total of 19 primary research articles were identified. The examined studies comprised case reports as well as case series and clinical single-arm studies (n = 7) with a limited number of participants. Reviewed studies revealed a high rate of procedural success (mean 84.6%; 95% confidence interval 66.6 to 93.8%) and durable clinical success (mean 69.0%; 95% confidence interval 51.8 to 82.2%). Failed attempts and incomplete closures were mainly ascribed to the challenging effort of treating highly fibrotic chronic fistulae.
Endoscopic closure of gastrointestinal fistulae by means of the OTSC System is a safe and effective method.
传统的内镜治疗方法用于闭合胃肠道瘘管存在若干局限性，因此复发率较高。本研究的目的是评估使用OTSC系统闭合胃肠道瘘管的初次技术成功率和二次临床成功率。
设计/方法：系统检索Medline数据库中关于评估OTSC系统闭合胃肠道瘘管的原始研究。两名评审员使用预先确定的数据提取表独立进行纳入研究的评估和数据提取。
共识别出19篇原始研究文章。所审查的研究包括病例报告、病例系列和临床单臂研究（n = 7），参与者数量有限。审查的研究显示手术成功率较高（平均84.6%；95%置信区间66.6%至93.8%），临床持久成功率较高（平均69.0%；95%置信区间51.8%至82.2%）。尝试失败和闭合不完全主要归因于治疗高度纤维化慢性瘘管的艰巨努力。
使用OTSC系统内镜闭合胃肠道瘘管是一种安全有效的方法。
