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Efficacy and feasibility of OverStitch suturing of leaks in the upper gastrointestinal tract.

Abstract

BACKGROUND

Management of upper gastrointestinal leaks is challenging. A new potential treatment option for this complication is endoscopic suturing with the OverStitch system (Apollo Endosurgery, Texas, USA), which is today mainly used for endoscopic sleeve gastroplasty. The aim of this study was to analyze the efficacy and feasibility of this new treatment option in patients with leaks in the upper gastrointestinal tract.

METHODS

We performed a retrospective, single-center study of all patients who underwent endoscopic suturing with OverStitch of leaks in the upper gastrointestinal tract.

RESULTS

Endoscopic suturing was performed on 13 patients (mean age, 59.62 ± 16.29 years; mean leak size, 22.31 ± 22.6 mm) over a period of 8 months. Postoperative leaks were detected in 10 patients (76.9%) after foregut surgery. Interventional success was achieved in all endoscopic attempts (n = 16, 100%) with a mean closure time of 28.0 ± 12.36 min per patient. Follow-up technical success rate for each suture was (n = 8, 50.0%). Clinical success, including repeated suture attempts was achieved in 8 of the 13 patients (61.5%). These 8 patients had not received prior treatment for the leak. No immediate or delayed serious complications occurred as a result of OverStitch. The mean follow-up was 95 ± 91.07 days.

CONCLUSIONS

Endoscopic suturing with OverStitch for leaks in the upper gastrointestinal tract is feasible and effective in patients who have not received prior treatment. This minimally invasive technique seems to be a promising option especially for patients with large leaks and significant comorbidities.

Authors+Show Affiliations

Department of General, Visceral, Cancer and Transplant Surgery, University Hospital of Cologne, Cologne, Germany. Seung-Hun.Chon@uk-koeln.de. Department of Gastroenterology and Hepatology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. Seung-Hun.Chon@uk-koeln.de. Interdisciplinary Endoscopy Unit, Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany. Seung-Hun.Chon@uk-koeln.de.Department of Gastroenterology and Hepatology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.Department of General, Visceral, Cancer and Transplant Surgery, University Hospital of Cologne, Cologne, Germany.Department of General, Visceral, Cancer and Transplant Surgery, University Hospital of Cologne, Cologne, Germany.Department of General, Visceral, Cancer and Transplant Surgery, University Hospital of Cologne, Cologne, Germany.Department of Gastroenterology and Hepatology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31591655

Citation

Chon, Seung-Hun, et al. "Efficacy and Feasibility of OverStitch Suturing of Leaks in the Upper Gastrointestinal Tract." Surgical Endoscopy, 2019.
Chon SH, Toex U, Plum PS, et al. Efficacy and feasibility of OverStitch suturing of leaks in the upper gastrointestinal tract. Surg Endosc. 2019.
Chon, S. H., Toex, U., Plum, P. S., Kleinert, R., Bruns, C. J., Goeser, T., & Berlth, F. (2019). Efficacy and feasibility of OverStitch suturing of leaks in the upper gastrointestinal tract. Surgical Endoscopy, doi:10.1007/s00464-019-07152-8.
Chon SH, et al. Efficacy and Feasibility of OverStitch Suturing of Leaks in the Upper Gastrointestinal Tract. Surg Endosc. 2019 Oct 7; PubMed PMID: 31591655.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and feasibility of OverStitch suturing of leaks in the upper gastrointestinal tract. AU - Chon,Seung-Hun, AU - Toex,Ulrich, AU - Plum,Patrick Sven, AU - Kleinert,Robert, AU - Bruns,Christiane Josephine, AU - Goeser,Tobias, AU - Berlth,Felix, Y1 - 2019/10/07/ PY - 2018/12/18/received PY - 2019/09/24/accepted PY - 2019/10/9/entrez PY - 2019/10/9/pubmed PY - 2019/10/9/medline KW - Complication management KW - Endoscopic suturing KW - Gastrointestinal perforation KW - OverStitch KW - Upper gastrointestinal surgery JF - Surgical endoscopy JO - Surg Endosc N2 - BACKGROUND: Management of upper gastrointestinal leaks is challenging. A new potential treatment option for this complication is endoscopic suturing with the OverStitch system (Apollo Endosurgery, Texas, USA), which is today mainly used for endoscopic sleeve gastroplasty. The aim of this study was to analyze the efficacy and feasibility of this new treatment option in patients with leaks in the upper gastrointestinal tract. METHODS: We performed a retrospective, single-center study of all patients who underwent endoscopic suturing with OverStitch of leaks in the upper gastrointestinal tract. RESULTS: Endoscopic suturing was performed on 13 patients (mean age, 59.62 ± 16.29 years; mean leak size, 22.31 ± 22.6 mm) over a period of 8 months. Postoperative leaks were detected in 10 patients (76.9%) after foregut surgery. Interventional success was achieved in all endoscopic attempts (n = 16, 100%) with a mean closure time of 28.0 ± 12.36 min per patient. Follow-up technical success rate for each suture was (n = 8, 50.0%). Clinical success, including repeated suture attempts was achieved in 8 of the 13 patients (61.5%). These 8 patients had not received prior treatment for the leak. No immediate or delayed serious complications occurred as a result of OverStitch. The mean follow-up was 95 ± 91.07 days. CONCLUSIONS: Endoscopic suturing with OverStitch for leaks in the upper gastrointestinal tract is feasible and effective in patients who have not received prior treatment. This minimally invasive technique seems to be a promising option especially for patients with large leaks and significant comorbidities. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/31591655/Efficacy_and_feasibility_of_OverStitch_suturing_of_leaks_in_the_upper_gastrointestinal_tract L2 - https://dx.doi.org/10.1007/s00464-019-07152-8 DB - PRIME DP - Unbound Medicine ER -