Prosst Ruediger
Proctological Institute Stuttgart, Stuttgart, Germany.
Minim Invasive Ther Allied Technol. 2019 Oct;28(5):261-267. doi: 10.1080/13645706.2018.1521837. Epub 2018 Oct 11.
OTSC Proctology is a minimally invasive sphincter-preserving technique for the surgical treatment of anorectal fistulas. It is based on a super-elastic Nitinol clip which closes the internal fistula opening to allow healing of the fistula tract. A systematic search of the literature was undertaken to identify publications about OTSC Proctology. All studies and reports identified were reviewed and evaluated to determine the feasibility, efficacy and safety of clip surgery. The assessment of all available studies with a total of more than 200 surgical cases strongly suggests that the clip procedure is safe and effective with a low rate of complications. The technique rendered convincing short and long term results with an overall healing rate of approximately 63%. Best results were achieved when OTSC Proctology was used as first-line treatment (healing rate 74%) and for cryptoglandular fistulas (healing rate 64%). However, its future clinical role for IBD-associated recurrent and anorecto-vaginal fistulas remains to be determined, due to a relatively low number of these patients in the evaluated studies. OTSC Proctology is part of the novel armamentarium for the treatment for anorectal fistulas, which is based on high-technology devices. They can be repeatedly used and even combined without causing irreversible sphincter damage.
OTSC直肠病学是一种用于手术治疗肛瘘的微创括约肌保留技术。它基于一种超弹性镍钛合金夹，该夹子可封闭肛瘘内口，使瘘管愈合。我们对文献进行了系统检索，以查找有关OTSC直肠病学的出版物。对所有检索到的研究和报告进行了审查和评估，以确定夹子手术的可行性、有效性和安全性。对所有涉及200多例手术病例的现有研究进行的评估强烈表明，夹子手术安全有效，并发症发生率低。该技术取得了令人信服的短期和长期效果，总体愈合率约为63%。当OTSC直肠病学作为一线治疗方法（愈合率74%）以及用于腺源性肛瘘（愈合率64%）时，取得了最佳效果。然而，由于在评估研究中这类患者数量相对较少，其在与炎症性肠病相关的复发性肛瘘和直肠阴道瘘的未来临床作用仍有待确定。OTSC直肠病学是基于高科技设备的新型肛瘘治疗手段的一部分。这些设备可以重复使用，甚至联合使用，而不会造成不可逆的括约肌损伤。
