Dr. Pietro Schettino
MD , PhD __ Medicina e Chirurgia __ CHIRURGIA DELL'APPARATO DIGERENTE ENDOSCOPIA DIGESTIVA CHIRURGICAArchivio per naples italy
The Over-The-Scope-Clip (OTSC) System is Effective in the Treatment of Chronic Esophagojejunal Anastomotic Leakage.
Galizia G, Napolitano V, Castellano P, Pinto M, Zamboli A, Schettino P, Orditura M, De Vita F, Auricchio A, Mabilia A, Pezzullo A, Lieto E.
Abstract
INTRODUCTION:
Management of postoperative esophagojejunal anastomotic leakage after total gastrectomy represents a very challenging event. Surgical repair is difficult, and conservative treatment can predispose to more severe complications. Endoclips and self-expanding stents are useful endoscopic therapeutic options but present some drawbacks. The Over-The-Scope-Clip (OTSC) system has been shown to be appropriate to close acute small gastrointestinal perforations, but its use in the treatment of chronic leakage remains controversial.
CASE SERIES:
The present series reports three consecutive chronic esophagojejunal anastomotic leaks successfully treated with OTSC. In all cases, clip application was simple, safe and effective, without early and late complications.
DISCUSSION:
The OTSC system may represent a new therapeutic option in the management of postoperative esophagojejunal anastomotic leakage.