Short-term outcomes of a novel endoscopic clipping device for closure of the internal opening in 100 anorectal fistulas
BackgroundOne hundred consecutive applications of a new clipping device, the OTSC® Proctology (Ovesco Endoscopy AG), were analyzed to assess its efficacy for the treatment of complex anorectal fistulas.MethodsIn patients with anorectal fistulas, minimally invasive surgery with the OTSC® Proctology s...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
26 September 2016
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| In: |
Techniques in coloproctology
Year: 2016, Volume: 20, Issue: 11, Pages: 753-758 |
| ISSN: | 1128-045X |
| DOI: | 10.1007/s10151-016-1537-0 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1007/s10151-016-1537-0
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| Author Notes: | R.L. Prosst, A.K. Joos |
MARC
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| 520 | |a BackgroundOne hundred consecutive applications of a new clipping device, the OTSC® Proctology (Ovesco Endoscopy AG), were analyzed to assess its efficacy for the treatment of complex anorectal fistulas.MethodsIn patients with anorectal fistulas, minimally invasive surgery with the OTSC® Proctology system was performed according to a standardized technique: the fistula tract was debrided using a special fistula brush, and the clip was applied on the internal fistula opening. In some of the patients, postoperative pain was evaluated using a visual analog scale. After 6 months, the postoperative clinical course and the fistula healing were assessed.ResultsA total of 100 OTSC® Proctology procedures were performed in 96 patients with 55 transsphincteric, 38 suprasphincteric, 2 extrasphincteric, and 5 rectovaginal fistulas. In all but 11 fistulas (8 Crohn’s disease, 3 ulcerative colitis), the fistulas were of cryptoglandular origin. The median operation time was 32 min (range 17-66 min). There were no major intraoperative technical problems. All patients found the postoperative pain to be tolerable with standard pain medication. The short-term results of 99 clip applications were analyzed: the healing rate for first-line fistula therapy was 79 %, whereas in recurrent fistulas, the success rate was 26 %. OTSC® Proctology was successful in 45 % of fistulas associated with inflammatory bowel disease and in 20 % of rectovaginal fistulas.ConclusionsOTSC® Proctology provides convincing results as first-line treatment for complex cryptoglandular fistulas. It is a safe, effective, minimally invasive, and sphincter-sparing procedure with postoperative pain comparable to other types of fistula surgery. | ||
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