Long-term outcomes of over-the-scope clip for refractory gastrointestinal diseases

• Published in: Minimally invasive therapy and allied technologies Vol. 31; no. 4; pp. 628 - 634
• Main Authors: Goda, Yasuhiro, Kobara, Hideki, Kobayashi, Nobuya, Nishiyama, Noriko, Fujihara, Shintaro, Tada, Naoya, Kozuka, Kazuhiro, Matsui, Takanori, Chiyo, Taiga, Shi, Tingting, Fujita, Koji, Tani, Joji, Yachida, Tatsuo, Takata, Masashi, Okano, Keiichi, Nakano, Daisuke, Nishiyama, Akira, Mori, Hirohito, Masaki, Tsutomu
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.04.2022
• Subjects: Endoscopic intervention; Endoscopy, Gastrointestinal - adverse effects; Fistula - complications; Gastrointestinal Diseases - complications; Gastrointestinal Hemorrhage - epidemiology; Gastrointestinal Hemorrhage - surgery; Humans; Over-the-scope clip; prognosis; refractory gastrointestinal disease; Retrospective Studies; Surgical Instruments; Treatment Outcome; refractory gastrointestinal disease; Over-the-scope clip; Endoscopic intervention; prognosis
• ISSN: 1364-5706; 1365-2931; 1365-2931
• DOI: 10.1080/13645706.2020.1867584

The Over-The-Scope Clip (OTSC) can effectively treat refractory gastrointestinal diseases. However, most reports have focused on short-term effectiveness. We examined clinical outcomes of the deployed clips and long-term characteristics. Of 47 patients with OTSC treatment, 35 with follow-up periods of ≥3 months were retrospectively examined. The indications were 11 bleedings, 17 perforations, and seven fistulas. The observation period was defined as medium-term (3 to <12 months) or long-term (≥12 months). The primary outcome was the clinical success rate without disease recurrence. The secondary outcomes were the complication rate, survival duration, and clip retention rate. The medium- and long-term clinical success rates were 100% during the observation period (median, 44 months; range, 3-78 months). The complication rate was 2.9% (n = 1). The median survival time was 1,634 days for bleeding, 1,757 days for perforation, and 444 days for fistulas. The overall clip retention rates were 56.4%, 38.1%, 30.9%, and 25.9% after one, six, and 12 months and at the final follow-up, respectively. The average clip retention duration was 244 days in bleeding, 656 days in perforations, and 188 days in fistulas. Regardless of clip detachment, the OTSC can be effective in long-term.