Meister T, Kuhlgatz J, Floer M
Acta Chir Belg. 2014 Jan-Feb;114(1):87-9.
Postoperative enterocutaneous fistulas are challenging with limited treatment options. The majority of patients with persistent fistula drainage flow require re-surgery. Recently the Over-The-Scope Clip (OTSC 11/6t, Ovesco Endoscopy, Tübingen, Germany) has become popular in Germany among surgeons and gastroenterologists for closure of perforations and bleeding vessels of the GI tract.
A 48-year-old female patient suffered from enterocutaneous fistula for four months located at the left upper corner within the enteric anastomosis of the jejunal loop leading to malnourishment. Prior attempts at fistula closure with fibrin glue application failed. An OTSC with sharp teeth (model 11/6t) was placed under continuous suction onto the fistula orifice with consecutive closure. The fistula remained closed even after a follow-up period of 12 months.
The authors demonstrate the technical feasibility of fistula closure by OTSC placement even in unfavorable enterocutaneous fistula positions possibly resulting in less surgical re-interventions in the future.
术后肠皮肤瘘治疗具有挑战性，治疗选择有限。大多数持续性瘘管引流的患者需要再次手术。最近，全层吻合夹（OTSC 11/6t，德国图宾根市Ovesco Endoscopy公司）在德国外科医生和胃肠病学家中已广泛用于闭合胃肠道穿孔和出血血管。
一名48岁女性患者患肠皮肤瘘4个月，瘘口位于空肠袢肠吻合口左上角，导致营养不良。先前应用纤维蛋白胶闭合瘘管的尝试失败。使用带尖齿的OTSC（型号11/6t）在持续吸引下放置于瘘口处并连续闭合。即使经过12个月的随访期，瘘管仍保持闭合。
作者证明了即使在不利的肠皮肤瘘位置，通过放置OTSC闭合瘘管在技术上是可行的，这可能会减少未来的外科再次干预。
