Outcomes of Endoscopic Intervention Using Over-the-Scope Clips for Anastomotic Leakage Involving Secondary Fistula after Gastrointestinal Surgery: A Japanese Multicenter Case Series
Naoya Tada,
Hideki Kobara,
Tomoaki Tashima,
Hayato Fukui,
Satoshi Asai,
Takumi Ichinona,
Koji Kojima,
Kunihisa Uchita,
Noriko Nishiyama,
Joji Tani,
Asahiro Morishita,
Akihiro Kondo,
Keiichi Okano,
Hajime Isomoto,
Kazuki Sumiyama,
Tsutomu Masaki,
Osamu Dohi
Affiliations
Naoya Tada
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Takamatsu 761-0793, Japan
Hideki Kobara
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Takamatsu 761-0793, Japan
Tomoaki Tashima
Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama 350-1298, Japan
Hayato Fukui
Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
Satoshi Asai
Department of Gastroenterology, Tane General Hospital, Osaka 550-0025, Japan
Takumi Ichinona
Department of Gastroenterology, Tane General Hospital, Osaka 550-0025, Japan
Koji Kojima
Department of Gastroenterology, Kochi Red Cross Hospital, Kochi 780-0026, Japan
Kunihisa Uchita
Department of Gastroenterology, Kochi Red Cross Hospital, Kochi 780-0026, Japan
Noriko Nishiyama
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Takamatsu 761-0793, Japan
Joji Tani
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Takamatsu 761-0793, Japan
Asahiro Morishita
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Takamatsu 761-0793, Japan
Akihiro Kondo
Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Takamatsu 761-0793, Japan
Keiichi Okano
Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Takamatsu 761-0793, Japan
Hajime Isomoto
Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan
Kazuki Sumiyama
Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan
Tsutomu Masaki
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Takamatsu 761-0793, Japan
Osamu Dohi
Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
Background: 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. Methods: We retrospectively collected data from 28 consecutive patients from five institutions who underwent OTSC-mediated closure for AL between July 2017 and July 2020. Results: The AL and fistula were located in the esophagus (3.6%, n = 1), stomach (10.7%, n = 3), small intestine (7.1%, n = 2), colon (25.0%, n = 7), and rectum (53.6%, n = 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 7 days (84.2%), and the use of simple suction (78.9%) and anchor forceps (80.0%) were associated with higher clinical success rates. Conclusion: OTSC placement is a useful therapeutic option for AL after gastrointestinal surgery.
