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Revista Colombiana de Gastroenterologia

Print version ISSN 0120-9957

Abstract

GOMEZ ZULETA, Martín A; RUIZ MORALES, Óscar Fernando  and  RIVEROS VEGA, Javier Humberto. Use of the over-the-scope clip (OTSC) system in the gastrointestinal tract: Experience at a third level center in Bogotá, Colombia. Rev Col Gastroenterol [online]. 2017, vol.32, n.2, pp.107-111. ISSN 0120-9957.  http://dx.doi.org/10.22516/25007440.137.

Perforations and fistulas of the gastrointestinal tract pose great therapeutic challenges and have usually been treated surgically. Recently, introduction of new endoscopic accessories has resulted in a growing trend of gastroenterological management of these patients. The “over-the-scope clip” (OTSC) system has shown itself to be useful for closing perforations of the gastrointestinal tract resulting from various causes.

Methods:

This paper presents a prospective case series of patients at a third level endoscopy center in Bogotá, Colombia who were treated in 2015. Experience with the use of the OTSC system in six patients with different indications is presented with at least three months of follow-up to assess recurrence.

Results:

Six cases, three men and three women, whose average age was 46.6 years were treated for a rectal perforation, a gastrocutaneous fistula following percutaneous gastrostomy, a posterior gastric fistula following bariatric surgery, gastric cancer through transmural clip resection, a rectal-vaginal fistula, and traumatic duodenal perforation. Successful closure of the lesion was achieved in five of the six cases, with a success rate of 83.3%.

Conclusions:

The OTSC system is useful system for closure of perforations of diverse etiologies in the gastrointestinal tract and is very efficient for closure of acute perforations. Nevertheless, it is not useful for chronic lesions such as rectal-vaginal fistulas. It may also be useful for new options such as transmural resection of early gastric cancer.

Keywords : Endoscopy; perforation; close; over-the-scope.

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