First clinical experiences with a novel endoscopic over-the-scope clip system

Dinelli, M.; Omazzi, Barbara; Andreozzi, Paolo; Zucchini, Nicola; Redaelli, A.; Manes, Gianpiero

doi:10.1055/s-0043-101692

Cited by 29 publications

(22 citation statements)

References 10 publications

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“…In the subgroup of SELs in this study, a high overall R0 resection rate was also observed (81 % in upper SELs and 100 % in lower SELs), making EFTR an attractive endoscopic alternative to surgery in cases where conventional endoscopic resection seems to be at high risk for severe AEs or unlikely to achieve complete resection. Notably, in the study by Kappelle et al [3], EFTR using the flat-based OTSC (Padlock clip) in the duodenum was complicated by perforation (n = 1) and micro perforation (n = 3), whereas no AEs were reported in other studies using this clip [10][11][12][13][14]18]. The use of the flat-based OTSC clip-assisted EFTR in the duodenum requires further technical refinements.…”

Section: E322mentioning

confidence: 96%

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Endoscopic full-thickness resection using a clip non-exposed method for gastrointestinal tract lesions: a meta-analysis

et al. 2020

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Background and study aims Endoscopic full-thickness resection (EFTR) allows for treatment of epithelial and sub-epithelial lesions (SELs) unsuitable to conventional resection techniques. This meta-analysis aimed to assess the efficacy and safety of clip-assisted method for non-exposed EFTR using FTRD or over-the-scope clip of gastrointestinal tumors. Methods A comprehensive literature search was performed. The primary outcome of interest was the rate of histologic complete resection (R0). Secondary outcomes of interest were the rate of enbloc resection, FTR, adverse events, and post-EFTR surgery. Random-effects model was used to calculate pooled estimates and generate forest plots. Results Eighteen studies with 730 patients and 733 lesions were included in the analyses. Indications for EFTR were difficult/residual colorectal adenoma, adenoma at a diverticulum or appendiceal orifice and early cancer (n = 634), colorectal SELs (n = 42), and upper gastrointestinal lesions (n = 51), other colonic lesions (n = 6). Median size of lesions was 13.5 mm. There were 22 failed EFTR attempts. Pooled overall R0 resection rate was 82 % (95 % CI: 75, 89). The pooled overall FTR rate was 83 % (95 % CI: 77, 89). The pooled overall enbloc resection rate was 95 (95 % CI: 92, 96). The pooled estimates for perforation and bleeding were < 0.1 % and 2 %, respectively. Following EFTR, a total of 110 patients underwent surgery for any reason [pooled rate 7 % (95 % 2, 14). The pooled rates for post-EFTR surgery due to invasive cancer, for non-curative endoscopic resection and for adverse events were 4 %, < 0.1 % and < 0.1 %, respectively. No mortality related to EFTR was noted. Conclusions EFTR appears to be safe and effective for gastrointestinal lesions that are not amenable to conventional endoscopic resection. This technique should be considered as an alternative to surgery in selected cases.

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Section: E322mentioning

confidence: 96%

“…Main characteristics of the included studies are provided in ▶ Table 1 [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Overall, 15 (83.3 %) studies were performed in Europe, two (11.1 %) being from the United States and one (5.5 %) from China.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Endoscopic full-thickness resection using a clip non-exposed method for gastrointestinal tract lesions: a meta-analysis

et al. 2020

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“…In recent years, endoscopic tools for achieving hemostasis have evolved, with a progressive increase of the success rate of therapeutic maneuvers. Novel technologies have been developed (i.e., new rotatable clips, Over-the-scope-clips (OTSC) clipping system, Padlock TM clips), and new hemostatic agents have been introduced in clinical practice (i.e., hemostatic powders or a novel self-assembling matrix-forming gel) [5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Treatments for Non-Variceal Upper GI Bleeding: A Review of the Literature

Angelis

Valdivia

Rizza

et al. 2020

JCM

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Endoscopic injection of glues, clotting factors, or sclerosing agents is a well-known therapy for the treatment of non-variceal upper gastrointestinal bleeding (NVUGIB), but less is known about endoscopic ultrasound (EUS)-guided treatments. In this setting, literature data are scarce, and no randomized controlled trials are available. We performed a review of the existing literature in order to evaluate the role of EUS-guided therapies in the management of NVUGIB. The most common treated lesions were Dieulafoy's lesions, pancreatic pseudoaneurysms, and gastrointestinal stromal tumors (GISTs). Mostly, the treatments were performed as a salvage option after failure of conventional endoscopic hemostatic attempts, showing good efficacy and a good safety profile, also documented by Doppler monitoring of treated lesions. EUS-guided therapies may be an effective option in the treatment of refractory NVUGIB, thus avoiding radiological or surgical management. Nevertheless, available literature still lacks robust data.

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“…Duodenal ulcers are definitely the leading cause of bleeding from the upper parts of the digestive tract [16]. Two traditional types of endoscopic therapy are the adrenaline therapy and the clip-based therapy [17,18]. Esophagogastroduodenoscopy is an efficient method for the diagnosis and treatment of the patients with bleeding from the upper parts of digestive tract [19].…”

Section: Discussionmentioning

confidence: 99%

The causes of upper gastrointestinal bleeding and urgent gastroscopy at the Center for Emergency Medicine of the Clinical Center Kragujevac

Milojković-Kicevska¹,

Kovačević²,

Janicijevic-Petrovic³

et al. 2019

Timočki medicinski glasnik

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Introduction: Digestive tract bleeding is a clinical problem that requires hospitalization. Hemorrhages from the upper parts of the digestive system have an incidence of 150/100000 persons per year and are the reason for 1.5% of all emergency hospitalizations. The most common cause of bleeding is gastroduodenal ulcer and erosion in three quarters of cases. Endoscopic haemostatic and gastric acidity status are the most important in the treatment of patients. Aim: To analyze the causes of bleeding from the upper parts of digestive tract and the justification for the urgent gastroscopy. The study was conducted at the Clinical Center Kragujevac in Kragujevac, Serbia. Methods: The study included patients (200) who reported to the emergency room of the Emergency Medicine Center with the clinical picture of bleeding from the upper parts of the digestive tract. Results: Most patients had ulcerative changes at gastric level (58.6%). The most common symptom was melena present in 152 patients. Endoscopic therapy was administered to 44 patients, with 38 patients (86.4%) resulting in arresting bleeding. Conclusion: Hemorrhages from the upper parts of the digestive tract are most commonly caused by peptic ulcers, more common in older, male patients. The first form of diagnosis and therapy is endoscopy, with an efficacy greater than 70%.

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First clinical experiences with a novel endoscopic over-the-scope clip system

Cited by 29 publications

References 10 publications

Endoscopic full-thickness resection using a clip non-exposed method for gastrointestinal tract lesions: a meta-analysis

Endoscopic full-thickness resection using a clip non-exposed method for gastrointestinal tract lesions: a meta-analysis

Endoscopic Ultrasound-Guided Treatments for Non-Variceal Upper GI Bleeding: A Review of the Literature

The causes of upper gastrointestinal bleeding and urgent gastroscopy at the Center for Emergency Medicine of the Clinical Center Kragujevac

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