Use of over-the-scope clips in the colon in clinical practice: results from a German administrative database.
Endoscopy
; 52(12): 1103-1110, 2020 12.
Article
en En
| MEDLINE
| ID: mdl-32869229
ABSTRACT
BACKGROUND:
The efficacy and safety of over-the-scope (OTS) clips in the colon is limited. This study aimed to evaluate OTS clip use in the colon in routine colonoscopy.METHODS:
Using administrative data from a large health insurance company, patients with OTS clip placement during colonoscopy were identified and analyzed by specific administrative codes. Indication for OTS clipping was analyzed, and follow-up was evaluated for surgical and repeat endoscopic interventions.RESULTS:
In 505 patients, indications for OTS clips were iatrogenic perforations (nâ=â80; Group A), polypectomy (nâ=â315; Group B), colonic bleeding (nâ=â51; Group C), and various underlying diseases (nâ=â59; Group D). In 11 Group A patients (13.8â%), surgical interventions occurred, mostly within 24 hours after clipping (nâ=â9), predominantly overstitching (nâ=â8). OTS clipping during polypectomy (Group B) was for complications (e.âg. bleeding in 27â%) or was applied prophylactically. Only five patients required early surgery, three of whom had colorectal cancer. In four Group C patients (7.8â%), surgical resections were performed (persistent bleeding nâ=â1, colorectal cancer nâ=â2), while six patients underwent early repeat colonoscopy for recurrent bleeding. During further follow-up (days 11-30), 17 patients underwent resection for colonic neoplasms (nâ=â12) or persistent bleeding (nâ=â4), but only one case could be directly traced back to local OTS clip complication.CONCLUSION:
Colonic OTS clipping appears safe and effective in selected indications and complications in clinical routine but must be anatomically and technically feasible, avoiding overuse.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Instrumentos Quirúrgicos
/
Enfermedades del Colon
Tipo de estudio:
Observational_studies
Límite:
Humans
Idioma:
En
Revista:
Endoscopy
Año:
2020
Tipo del documento:
Article
País de afiliación:
Alemania