Tada Naoya, Kobara Hideki, Tashima Tomoaki, Fukui Hayato, Asai Satoshi, Ichinona Takumi, Kojima Koji, Uchita Kunihisa, Nishiyama Noriko, Tani Joji, Morishita Asahiro, Kondo Akihiro, Okano Keiichi, Isomoto Hajime, Sumiyama Kazuki, Masaki Tsutomu, Dohi Osamu
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Takamatsu 761-0793, Japan.
Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
Diagnostics (Basel). 2023 Sep 19;13(18):2997. doi: 10.3390/diagnostics13182997.
The over-the-scope clip (OTSC) is a highly effective clipping device for refractory gastrointestinal disease. However, Japanese data from multicenter studies for anastomotic leakage (AL) involving a secondary fistula after gastrointestinal surgery are lacking. Therefore, this study evaluated the efficacy and safety of OTSC placement in Japanese patients with such conditions.
We retrospectively collected data from 28 consecutive patients from five institutions who underwent OTSC-mediated closure for AL between July 2017 and July 2020.
The AL and fistula were located in the esophagus (3.6%, = 1), stomach (10.7%, = 3), small intestine (7.1%, = 2), colon (25.0%, = 7), and rectum (53.6%, = 15). The technical success, clinical success, and complication rates were 92.9% (26/28), 71.4% (20/28), and 0% (0/28), respectively. An age of <65 years (85.7%), small intestinal AL (100%) and colonic AL (100%), defect size of <10 mm (82.4%), time to OTSC placement > 7 days (84.2%), and the use of simple suction (78.9%) and anchor forceps (80.0%) were associated with higher clinical success rates.
OTSC placement is a useful therapeutic option for AL after gastrointestinal surgery.
内镜下圈套夹（OTSC）是治疗难治性胃肠疾病的一种高效夹闭装置。然而，目前缺乏来自日本多中心研究中关于胃肠手术后吻合口漏（AL）合并继发性瘘的数据。因此，本研究评估了OTSC置入术在日本此类患者中的疗效和安全性。
我们回顾性收集了2017年7月至2020年7月期间来自5家机构的28例连续接受OTSC介导的AL闭合术患者的数据。
AL和瘘位于食管（3.6%，1例）、胃（10.7%，3例）、小肠（7.1%，2例）、结肠（25.0%，7例）和直肠（53.6%，15例）。技术成功率、临床成功率和并发症发生率分别为92.9%（26/28）、71.4%（20/28）和0%（0/28）。年龄<65岁（85.7%）、小肠AL（100%）和结肠AL（100%）、缺损大小<10 mm（82.4%）、OTSC置入时间>7天（84.2%）以及使用单纯吸引（78.9%）和锚定钳（80.0%）与较高的临床成功率相关。
OTSC置入术是胃肠手术后AL的一种有用治疗选择。
