Literature DB >> 25984980

A Large Multicenter Experience With Endoscopic Suturing for Management of Gastrointestinal Defects and Stent Anchorage in 122 Patients: A Retrospective Review.

Reem Z Sharaiha1, Nikhil A Kumta, Ersilia M DeFilippis, Christopher J Dimaio, Susana Gonzalez, Tamas Gonda, Jason Rogart, Ali Siddiqui, Paul S Berg, Paul Samuels, Larry Miller, Mouen A Khashab, Payal Saxena, Monica R Gaidhane, Amy Tyberg, Julio Teixeira, Jessica Widmer, Prashant Kedia, David Loren, Michel Kahaleh, Amrita Sethi.   

Abstract

GOALS: To describe a multicenter experience using an endoscopic suturing device for management of gastrointestinal (GI) defects and stent anchorage.
BACKGROUND: Endoscopic closure of GI defects including perforations, fistulas, and anastomotic leaks as well as stent anchorage has improved with technological advances. An endoscopic suturing device (OverStitch; Apollo Endosurgery Inc.) has been used. STUDY: Retrospective study of consecutive patients who underwent endoscopic suturing for management of GI defects and/or stent anchorage were enrolled between March 2012 and January 2014 at multiple academic medical centers. Data regarding demographic information and outcomes including long-term success were collected.
RESULTS: One hundred and twenty-two patients (mean age, 52.6 y; 64.2% females) underwent endoscopic suturing at 8 centers for stent anchorage (n=47; 38.5%), fistulas (n=40; 32.7%), leaks (n=15; 12.3%), and perforations (n=20; 16.4%). A total of 44.2% underwent prior therapy and 97.5% achieved technical success. Immediate clinical success was achieved in 79.5%. Long-term clinical success was noted in 78.8% with mean follow-up of 68 days. Clinical success was 91.4% in stent anchorage, 93% in perforations, 80% in fistulas, but only 27% in anastomotic leak closure.
CONCLUSIONS: Endoscopic suturing for management of GI defects and stent anchoring is safe and efficacious. Stent migration after stent anchoring was reduced compared with published data. Long-term success without further intervention was achieved in the majority of patients. The role of endoscopic suturing for repair of anastomotic leaks remains unclear given limited success in this retrospective study.

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Year:  2016        PMID: 25984980     DOI: 10.1097/MCG.0000000000000336

Source DB:  PubMed          Journal:  J Clin Gastroenterol        ISSN: 0192-0790            Impact factor:   3.062


  15 in total

Review 1.  Endoscopic management of perforations, leaks and fistulas.

Authors:  Ritu Raj Singh; Jeremy S Nussbaum; Nikhil A Kumta
Journal:  Transl Gastroenterol Hepatol       Date:  2018-10-31

Review 2.  Endoscopic Management of Esophageal Perforations: Who, When, and How?

Authors:  Payal Saxena; Mouen A Khashab
Journal:  Curr Treat Options Gastroenterol       Date:  2017-03

Review 3.  Endoscopic Management of Benign Esophageal Ruptures and Leaks.

Authors:  Milena Di Leo; Roberta Maselli; Elisa Chiara Ferrara; Laura Poliani; Sameer Al Awadhi; Alessandro Repici
Journal:  Curr Treat Options Gastroenterol       Date:  2017-06

4.  Esophageal stent fixation with endoscopic suturing device improves clinical outcomes and reduces complications in patients with locally advanced esophageal cancer prior to neoadjuvant therapy: a large multicenter experience.

Authors:  Juliana Yang; Ali A Siddiqui; Thomas E Kowalski; David E Loren; Ammara Khalid; Ayesha Soomro; Syed M Mazhar; Julian Rosé; Laura Isby; Michel Kahaleh; Ankush Kalra; Alex M Sarkisian; Nikhil A Kumta; Jose Nieto; Reem Z Sharaiha
Journal:  Surg Endosc       Date:  2016-08-05       Impact factor: 4.584

5.  Stent migration following endoscopic suture fixation of esophageal self-expandable metal stents: a systematic review and meta-analysis.

Authors:  Ryan Law; Anoop Prabhu; Larissa Fujii-Lau; Carol Shannon; Siddharth Singh
Journal:  Surg Endosc       Date:  2017-07-19       Impact factor: 4.584

6.  Endoscopic Suturing Results in High Technical and Clinical Success Rates for a Variety of Gastrointestinal Pathologies.

Authors:  Zachary M Callahan; Bailey Su; Kristine Kuchta; Eliza Conaty; Stephanie Novak; John Linn; Faris M Murad; JoAnn Carbray; Michael Ujiki
Journal:  J Gastrointest Surg       Date:  2019-12-10       Impact factor: 3.452

Review 7.  Esophageal Perforations: An Endoscopic Approach to Management.

Authors:  Shelly Gurwara; Steven Clayton
Journal:  Curr Gastroenterol Rep       Date:  2019-11-20

8.  Endoscopic Management of Esophageal Anastomotic Leaks After Surgery for Malignant Disease.

Authors:  Eugene Licht; Arnold J Markowitz; Manjit S Bains; Hans Gerdes; Emmy Ludwig; Robin B Mendelsohn; Nabil P Rizk; Pari Shah; Vivian E Strong; Mark A Schattner
Journal:  Ann Thorac Surg       Date:  2015-09-28       Impact factor: 4.330

Review 9.  The Use of the Overstitch to Close Perforations and Fistulas.

Authors:  Phillip S Ge; Christopher C Thompson
Journal:  Gastrointest Endosc Clin N Am       Date:  2019-10-29

10.  Acute upper gastrointestinal bleeding: A stitch on time saves nine.

Authors:  Nishkarsh Gupta; Anju Gupta
Journal:  World J Gastrointest Endosc       Date:  2022-05-16
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