A large multicenter experience with endoscopic suturing for management of gastrointestinal defects and stent anchorage in 122 patients: A retrospective review

Reem Z. Sharaiha, 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 Khashab, Payal Saxena, Monica R. Gaidhane, Amy Tyberg, Julio Teixeira, Jessica Widmer, Prashant Kedia, David Loren, Michel KahalehAmrita Sethi

Research output: Contribution to journalReview articlepeer-review

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%. Longterm 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. Longterm 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.

Original languageEnglish (US)
Pages (from-to)388-392
Number of pages5
JournalJournal of clinical gastroenterology
Volume50
Issue number5
DOIs
StatePublished - 2016

Keywords

  • Closure
  • Defect
  • Fistula
  • OverStitch
  • Stent anchorage

ASJC Scopus subject areas

  • Gastroenterology

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