Endoscopic management of post-surgical GI wall defects with the overstitch endosuturing system: a single-center experience

Granata, Antonino; Amata, Michele; Ligresti, Dario; Martino, Alberto; Tarantino, Ilaria; Barresi, Luca; Traina, Mario

doi:10.1007/s00464-019-07145-7

Cited by 15 publications

(10 citation statements)

References 49 publications

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“…No serious AEs or procedurerelated deaths occurred. Previously published studies have reported AE rates of 0% to 5.1% for TTS clips, 2,14 0% to 38.4% for OTS clips, 1,[17][18][19][20]23 and 0% to 43% for endoscopic suturing, 3,15,[24][25][26] with abdominal pain and bleeding the most commonly described AEs. The rate of AEs for the tack and suture system compares favorably with these devices.…”

Section: Discussionmentioning

confidence: 92%

Initial multicenter experience using a novel endoscopic tack and suture system for challenging GI defect closure and stent fixation (with video)

Mahmoud

Song

Stavropoulos

et al. 2022

Gastrointestinal Endoscopy

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Background and Aims: Closure of endoscopic resection defects can be achieved with through-the-scope clips, over-the-scope clips, or endoscopic suturing. However, these devices are often limited by their inability to close large, irregular, and difficult-to-reach defects. Thus, we aimed to assess the feasibility and safety of a novel through-the-scope, suture-based closure system developed to overcome these limitations.Methods: This was a retrospective multicenter study involving 8 centers in the United States. Primary outcomes were feasibility and safety of early use of the device. Secondary outcomes were assessment of need for additional closure devices, prolonged procedure time, and technical feasibility of performing the procedure with an alternative device(s).Results: Ninety-three patients (48.4% women) with mean age 63.6 AE 13.1 years were included. Technical success was achieved in 83 patients (89.2%), and supplemental closure was required in 24.7% of patients (n Z 23) with a

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Section: Discussionmentioning

confidence: 92%

Initial multicenter experience using a novel endoscopic tack and suture system for challenging GI defect closure and stent fixation (with video)

Mahmoud

Song

Stavropoulos

et al. 2022

Gastrointestinal Endoscopy

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“… 5 Although several articles reported that tuberculous bronchoesophageal fistula could be cured by antituberculosis drugs alone, some patients in these articles had no medical history of tuberculosis or had not taken antituberculosis drugs regularly before the fistula formation. 11 Although the OverStitch endoscopic suturing system was a reported valid alternative to conventional therapy, 7 it is still unavailable or unaffordable for many patients in China. In the current case, the patient was taking antituberculosis medications regularly when her fistula occurred.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Endoscopic interventions to limit fistula output comprise clips, metal stents, medical adhesives, the OverStitch system (Apollo Endosurgery, Austin, TX, USA), and over-the-scope clips (OTSC). 6 – 7 When the effects of these treatments are unsatisfactory or these options are not accepted by the patient, subsequent treatment may be challenging. Herein, we report a complicated case of tuberculous bronchoesophageal fistula successfully managed by combined therapy with endoscopic submucosal dissection (ESD)-based suture and medical adhesive.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic submucosal dissection-based suture combined with medical adhesive for complicated tuberculous bronchoesophageal fistula: a case report

2022

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Tuberculous bronchoesophageal fistula is a rare complication of tuberculosis. Herein, we report the case of a woman in her late 60s with a choking cough for more than 1 month. Iohexol esophagography revealed a fistulous communication between the esophagus and the right principal bronchus, and gastroscopy documented a fistulous orifice in the esophagus. Endoscopic closure with metal clips failed, and other treatment options, such as extended conservative treatment, covered self-expandable metal stents, and over-the-scope clips were rejected by the patient. Therefore, a combined therapy, endoscopic submucosal dissection-based suture combined with medical adhesive, was performed. Follow-up iohexol esophagography and gastroscopy confirmed fistula closure. During 1 year of follow-up after discharge, the bronchoesophageal fistula did not recur. Endoscopic submucosal dissection-based suture combined with medical adhesive appears to be a practical and feasible solution to complicated tuberculous bronchoesophageal fistula.

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“…Endoscopic suturing can also be used for esophageal stent fixation in order to prevent migration [ 29 ]. In this regard, Granata et al reported a recent case series of 20 patients with post-operative leaks [ 61 ]. The therapeutic approach was stratified in three groups according to the clinical scenario and structural condition of the wall defect layers: Pure endoscopic direct suture (group A: healthy tissue and feasible suture), combined therapy with endoscopic direct suture + FC-SEMS placement + anchoring (group B: unhealthy tissue and feasible sutures) and FC-SEMS placement + anchoring (group C: unhealthy tissue and suture not feasible).…”

Section: Endoscopic Techniquesmentioning

confidence: 99%

Endoscopic Management of Postoperative Esophageal and Upper GI Defects—A Narrative Review

et al. 2023

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Anastomotic defects are deleterious complications after either oncologic or bariatric surgery, leading to high morbidity and mortality. Besides surgical revision in early stages or instable patients, endoscopic treatment has become the mainstay. To date, many options for endoscopic treatment in this setting exist, including fully covered metal stent placement, endoscopic vacuum therapy (EVT), endoscopic internal drainage with pigtail placement (EID), leak closure with through the scope or over the scope clips, endoluminal suturing, fibrin glue sealing and a combination of all these techniques. Current evidence is mostly based on retrospective single and multicenter studies. No guidelines exist in this important field. Treatment options have to be chosen upon each case individually, taking into account clinical and anatomic criteria, such as timing, size, infectious wound complications and hemodynamic stability. Local expertise and availability of treatment devices need to be taken into account whenever choosing a treatment strategy. This review aimed to present current treatment options in terms of effectiveness, advantages and disadvantages in order to guide the clinician for his decision making. Additionally, we aimed to provide a treatment algorithm.

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Endoscopic management of post-surgical GI wall defects with the overstitch endosuturing system: a single-center experience

Cited by 15 publications

References 49 publications

Initial multicenter experience using a novel endoscopic tack and suture system for challenging GI defect closure and stent fixation (with video)

Initial multicenter experience using a novel endoscopic tack and suture system for challenging GI defect closure and stent fixation (with video)

Endoscopic submucosal dissection-based suture combined with medical adhesive for complicated tuberculous bronchoesophageal fistula: a case report

Endoscopic Management of Postoperative Esophageal and Upper GI Defects—A Narrative Review

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