Rapid and effective closure of gastrocutaneous (GC) fistulae using this device has been recently described in the literature. The Over-The-Scope-Clip (OTSC) has had an evolving role in endoscopic closure of gastrointestinal wall defects, in hemostasis of primary or postinterventional bleeding, and approximation of postbariatric surgery defects. Singhal, Shashideep Changela, Kinesh Culliford, Andrea Duddempudi, Sushil Krishnaiah, Mahesh Anand, Sury PMID:26136836Įndoscopic closure of persistent gastrocutaneous fistulae, after percutaneous endoscopic gastrostomy (PEG) tube placement, using the over-the-scope-clip system. Conclusions: OTSC application is a safe and effective endoscopic approach for the closure of persistent GC fistulae secondary to a complication of PEG tube placement. A limitation of this study was that there was no control group. The mean follow-up time after OTSC application was 43.7 Â± 20.57 days. In the OTSC group, microscopic ulcers were present in two pigs (25Â %), cryptal abscesses in three pigs (38Â %) and significant neutrophil accumulation in all eight pigs (PÂ 2.5 cm) and those with significant fibrosis were more difficult to close with the OTSC system. Microscopically, no inflammatory changes were observed after KING closure. At autopsy, all KING closures (100Â %) were healed with a flat scar without signs of leakage. The duration of closure was similar in both techniques (OTSC 17.8Â Â±Â 7.6Â min vs. All closures were completed successfully without air leaks. Then, autopsy was performed and the rectosigmoid was sent for histopathological assessment. Pigs underwent a control sigmoidoscopy 8Â months after the closure to assess the macroscopic quality of healing. OTSC closure (nÂ =Â 8) was performed by deploying OTSC (OVESCO) over the defect. KING closure (nÂ =Â 8) was attained by approximation of an endoloop fixed to the margins of a perforation with endoclips. A standardized perforation was performed on the anterior sigmoid wall. We performed a randomized experimental study with 16 mini-pigs (mean weight 43.2Â Â±Â 11.2Â kg). To compare OTSC versus KING closure of a perforation with regard to long-term effectiveness and macroscopic and histological quality of healing.

Nevertheless, OTSC clip demonstrated significantly inferior histological healing in the short-term follow-up. Complete closure of post-ESD artificial gastric ulcer using a combination of a single OTSC and TTSCs is useful for shortening the period of hospitalization and reducing treatment cost.Ī comparison of two endoscopic closures: over-the-scope clip (OTSC) versus KING closure (endoloopÂ +Â clips) in a randomized long-term experimental study.ĭolezel, R Ryska, O Kollar, M Juhasova, J Kalvach, J Ryska, M Martinek, Jīoth over-the-scope clip (OTSC) and KING (endoloopÂ +Â clips) closures provide reliable and safe full-thickness endoscopic closure. Patients who underwent complete closure of post-ESD artificial gastric ulcer could be discharged the day after ESD and the closing procedure. The mean operating time for the closure procedure was 15.2 min., and the success rate was 91.7 % (11/12). Mean size of post-ESD artificial ulcer was 54.6 mm. We performed complete closure of post-ESD artificial gastric ulcer using a combination of a single OTSC and TTSCs. We prospectively studied 12 patients with early gastric cancer or gastric adenoma. The aim of this study was to evaluate the efficacy of combined use of a single over-the-scope clip (OTSC) and through- the-scope clips (TTSCs) to achieve complete closure of artificial gastric ulcer after ESD. Maekawa, Satoshi Nomura, Ryosuke Murase, Takayuki Ann, Yasuyoshi Harada, MasaruĪ 5-7 day hospital stay is usually needed after endoscopic submucosal dissection (ESD) of gastric tumor because of the possibility of delayed perforation or bleeding. Complete closure of artificial gastric ulcer after endoscopic submucosal dissection by combined use of a single over-the-scope clip and through- the-scope clips (with videos).

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