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在日常内镜诊疗中使用全层吻合夹(OTSC®)。

Establishment of Over-The-Scope-Clips (OTSC®) in daily endoscopic routine.

作者信息

Honegger C, Valli P V, Wiegand N, Bauerfeind P, Gubler C

机构信息

Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.

出版信息

United European Gastroenterol J. 2017 Mar;5(2):247-254. doi: 10.1177/2050640616657273. Epub 2016 Jul 7.

Abstract

BACKGROUND

Alongside the evolution of interventional endoscopy, the need for a more sophisticated closure tool tailored to the treatment of new challenging indications has been increasing rapidly.

METHODS

We here present our collected data on 262 Over-The-Scope-Clip (OTSC®) placements in a total of 233 interventions at our institution. Follow-up was focused on clinically lasting success with regards to different indications.

RESULTS

Immediate success of OTSC® treatment was observed in 87.1% of all sessions (203/233). The success rates were as follows: spontaneous bleeding 84.8% (28/33); iatrogenic bleeding 100% (20/20); acute perforation 90.3% (65/72); prophylaxis for perforation 100% (24/24); anastomotic leakage 61.1% (11/18); fistulae 80.7% (46/57); diameter reduction of the gastrojejunal anastomosis 100% (6/6); and stent fixation 100% (3/3). At 30-day follow-up, the overall success rate was 67.4% (157/233). The success rates were as follows: spontaneous bleeding 69.7% (23/33); iatrogenic bleeding 90% (18/20); acute perforation 86.1% (62/72); prophylaxis for perforation 100% (24/24); anastomotic leakage 33.3% (6/18); fistulae 29.8% (17/57), diameter reduction of the gastrojejunal anastomosis 83.3% (5/6); and stent fixation 66% (2/3).

CONCLUSIONS

Our cohort confirms previous data on the clinical usefulness of the OTSC® in daily routine practice.

摘要

背景

随着介入性内镜技术的发展,对于针对新的具有挑战性适应症的治疗而设计的更复杂闭合工具的需求迅速增加。

方法

我们在此展示了在我们机构进行的总共233例干预中262次使用圈套夹(OTSC®)的数据。随访重点是针对不同适应症的临床持久成功率。

结果

在所有治疗中,87.1%(203/233)的OTSC®治疗立即成功。成功率如下:自发性出血84.8%(28/33);医源性出血100%(20/20);急性穿孔90.3%(65/72);穿孔预防100%(24/24);吻合口漏61.1%(11/18);瘘管80.7%(46/57);胃空肠吻合口直径缩小100%(6/6);以及支架固定100%(3/3)。在30天随访时,总体成功率为67.4%(157/233)。成功率如下:自发性出血69. | 7%(23/33);医源性出血90%(18/20);急性穿孔86.1%(62/72);穿孔预防100%(24/24);吻合口漏33.3%(6/18);瘘管29.8%(17/57);胃空肠吻合口直径缩小83.3%(5/6);以及支架固定66%(2/3)。

结论

我们的队列证实了先前关于OTSC®在日常临床实践中的临床实用性的数据。

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