Long-term outcomes of over-the-scope clip for refractory gastrointestinal diseases

Abstract

Background

The Over-The-Scope Clip (OTSC) can effectively treat refractory gastrointestinal diseases. However, most reports have focused on short-term effectiveness. We examined clinical outcomes of the deployed clips and long-term characteristics.

Material and methods

Of 47 patients with OTSC treatment, 35 with follow-up periods of ≥3 months were retrospectively examined. The indications were 11 bleedings, 17 perforations, and seven fistulas. The observation period was defined as medium-term (3 to <12 months) or long-term (≥12 months). The primary outcome was the clinical success rate without disease recurrence. The secondary outcomes were the complication rate, survival duration, and clip retention rate.

Results

The medium- and long-term clinical success rates were 100% during the observation period (median, 44 months; range, 3–78 months). The complication rate was 2.9% (n = 1). The median survival time was 1,634 days for bleeding, 1,757 days for perforation, and 444 days for fistulas. The overall clip retention rates were 56.4%, 38.1%, 30.9%, and 25.9% after one, six, and 12 months and at the final follow-up, respectively. The average clip retention duration was 244 days in bleeding, 656 days in perforations, and 188 days in fistulas.

Conclusions

Regardless of clip detachment, the OTSC can be effective in long-term.

Keywords:

• Endoscopic intervention
• Over-the-scope clip
• refractory gastrointestinal disease
• prognosis

Acknowledgement

We thank Angela Morben, DVM, ELS, from Edanz Group (https://en-author-services.edanzgroup.com/), for editing a draft of this manuscript.

Declaration of interest

No potential conflict of interest was reported by the author(s).

Compliance with ethical standards

All data were entered into a central database at Kagawa University. This study was approved by the Clinical Ethics Committee of Kagawa University Hospital (Registration number: 2019-187) and the ethics committees of the other two institutions that participated in the study in accordance with the Declaration of Helsinki, and the CONSORT checklist was followed. All patients provided written informed consent to undergo the procedures and participate in the study.