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Revista Colombiana de Cirugía

Print version ISSN 2011-7582On-line version ISSN 2619-6107

Abstract

PINILLA-MORALES, Raúl E. et al. Management of perforations, leaks and fistulas of the gastrointestinal tract with over the scope clip. Experience at a Latin American cancer center. rev. colomb. cir. [online]. 2023, vol.38, n.2, pp.259-267.  Epub Jan 21, 2023. ISSN 2011-7582.  https://doi.org/10.30944/2011758.2197.

Introduction.

Fistula of the digestive tract derived from neoplastic diseases as well as leaks following surgical procedures are not uncommon and usually cause significant morbidity when are managed surgically. Diagnostic and therapeutic endoscopic procedures may present perforations during their performance; if they are managed non-operatively, an adequate recovery is obtained. The purpose of this study was to describe the clinical characteristics and the short- and long-term outcomes of patients with perforations, fistulas and leaks of the gastrointestinal tract managed endoscopically with over the scope clip (OTSC).

Methods.

Descriptive, retrospective study of patients brought to digestive endoscopy with OTSC placement with diagnosis of postoperative perforation, leak or fistula at the National Cancer Institute in Bogota, Colombia, between January 2016 and April 2020.

Results.

Twenty-one patients were taken for OTSC application for the management of perforations, leaks and fistulas of the gastrointestinal tract, 52.4% of them were women. The median age was 66 years. The median diameter of the defect was 9 mm. Technical success was achieved in 95%. Early clinical success was described in 85.7% of the cases; 76.1% of patients remained symptom-free at 3-month follow-up.

Conclusions.

Management of perforations, leaks and fistulas with OTSC appears to be feasible and safe. In most of these patients, clip release and endoscopic identification of closure was achieved immediately after management; however, in the case of fistulas, late clinical success was not achieved in all cases.

Keywords : intestinal perforation; intestinal fistula; anastomotic leak; digestive system endoscopy; gastrointestinal endoscopy; OVESCO.

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