RSS-Feed abonnieren
DOI: 10.1055/s-0034-1365513
Over-the-scope clip-assisted method for resection of full-thickness submucosal lesions of the gastrointestinal tract
Publikationsverlauf
submitted 14. Januar 2014
accepted after revision 11. März 2014
Publikationsdatum:
15. Mai 2014 (online)
![](https://www.thieme-connect.de/media/endoscopy/201409/lookinside/thumbnails/10.1055-s-0034-1365513-1.jpg)
Background and study aims: The over-the-scope clip (OTSC; Ovesco Endoscopy, Tübingen, Germany) is deployed after suctioning tissue into the cap. The tissue may then be resected endoscopically. The aim of this study was to evaluate the efficacy and safety of the OTSC for the endoscopic resection of gastrointestinal tumors.
Patients and methods: This was a retrospective, observational cohort study of patients undergoing endoscopic resection of submucosal lesions.
Results: Eight patients underwent endoscopic resection of neuroendocrine tumors (NETs) of the duodenum (n = 4), rectum (n = 1), or stomach (n = 2), or granular cell tumor (GCT) of the esophagus (n = 1). The mean size of the lesions was 13.4 mm (range 9 – 20 mm). Application of the clip was successful in all patients. A successful endoscopic resection was accomplished in all. A complete resection (R0) was accomplished in 7/8 patients (87.5 %). A full-thickness resection was achieved in 2/8 (25.0 %), one in a patient with a gastric NET and the other in a patient with GCT of the esophagus. There were no complications.
Conclusions: This case series suggests that the OTSC system may be a valuable tool for the resection of submucosal lesions, but further prospective and randomized studies are necessary to assess the indications and outcome.
-
References
- 1 Pohl J, Borgulya M, Lorenz D et al. Endoscopic closure of postoperative esophageal leaks with a novel over-the-scope clip system. Endoscopy 2010; 42: 757-759
- 2 Seebach L, Bauerfeind P, Gubler C. “Sparing the surgeon”: clinical experience with over-the-scope clips for gastrointestinal perforation. Endoscopy 2010; 42: 1108-1111
- 3 Manta R, Manno M, Bertani H et al. Endoscopic treatment of gastrointestinal fistulas using an over-the-scope clip (OTSC) device: case series from a tertiary referral center. Endoscopy 2011; 43: 545-548
- 4 Sandmann M, Heike M, Fähndrich M. Application of the OTSC system for the closure of fistulas, anastomosal leakages and perforations within the gastrointestinal tract. Z Gastroenterol 2011; 49: 981-985
- 5 Mönkemüller K, Toshniwal J, Zabielski M et al. Utility of the “bear claw”, or over-the-scope clip (OTSC) system, to provide endoscopic hemostasis for bleeding posterior duodenal ulcers. Endoscopy 2012; 44: E412-413
- 6 Voermans RP, Le Moine O, von Renteln D. CLIPPER Study Group et al. Efficacy of endoscopic closure of acute perforations of the gastrointestinal tract. Clin Gastroenterol Hepatol 2012; 10: 603-608
- 7 von Renteln D, Rösch T, Kratt T et al. Endoscopic full-thickness resection of submucosal gastric tumors. Dig Dis Sci 2012; 57: 1298-1303
- 8 von Renteln D, Schmidt A, Vassiliou MC et al. Endoscopic full-thickness resection and defect closure in the colon. Gastrointest Endosc 2010; 71: 1267-1273
- 9 Raju GS, Gomez G. Endoloop ligation of a large colonic lipoma: a novel technique. Gastrointestinal Endosc 2005; 62: 988-990
- 10 Baron TH, Song LM, Ross A et al. Use of an over-the-scope clipping device: multicenter retrospective results of the first U.S. experience (with videos). Gastrointest Endosc 2012; 76: 202-208
- 11 Mönkemüller K, Peter S, Alkurdi B et al. Endoscopic closure of a gastrocolic fistula using the over-the-scope-clip-system. World J Gastrointest Endosc 2013; 5: 402-406
- 12 Schlag C, Wilhelm D, von Delius S et al. EndoResect study: endoscopic full-thickness resection of gastric subepithelial tumors. Endoscopy 2013; 45: 4-11
- 13 Picasso M, Parodi A, Fisher DA et al. Full thickness endoscopic resection of a colonic cancer: a case report. Clin Res Hepatol Gastroenterol 2013; 37: e99-e101
- 14 Neumann H, Diebel H, Mönkemüller K et al. Description of a new, endoscopic technique to remove the over-the-scope-clip in an ex vivo porcine model (with video). Gastrointest Endosc 2012; 76: 1009-1013
- 15 Mönkemüller K, Toshniwal J, Zabielski M. Endoscopic removal of an over-the-scope-clip (“bear claw”). Gastrointest Endosc 2012; 76: 1077-1078
- 16 Fähndrich M, Sandmann M, Heike M. Removal of over the scope clips (OTSC) with an Nd:YAG Laser. Z Gastroenterol 2011; 49: 579-583