Two Cases in Which the Use of an Over-the-Scope-Clip System Was Effective in Closing Ruptured Sutures and Repairing Fistulas Following Upper Gastrointestinal Surgery

Abstract

Suture rupture is a relatively frequent postoperative complication after upper gastrointestinal surgery. Treatment consists mainly of drainage and nutritional management; however, the disadvantage of this treatment is that in some cases, formation and growth of granulation tissue may take a long time to complete. The use of an over-the-scope-clip system (OTSC) for the closure of all layers of the gastrointestinal wall has recently been recognized to enable earlier closure of fistulas after surgery. We encountered two cases in which fistula closure was successful after OTSC was used to treat postoperative suture ruptures and fistulas occurring after upper gastrointestinal surgery. Complete closure was achieved immediately after OTSC in Case 1, and at day 3 after OTSC in Case 2. OTSC is an aggressive treatment that differs from the conventional treatment method. It consists of closing ruptured sutures with an endoscope. The use of OTSC markedly reduces the time needed to wait for the growth of granulation tissue, and as a result, it may potentially lead to a shortening of the hospital stay as well as a reduction of the burden on patients. Our findings suggested that fistula closure using OTSC could be a new option in the treatment of postoperative complications.