GUIDELINE: Deep sedation with propofol for gastrointestinal endoscopy not administered by anesthesiologists

Deep sedation with propofol for gastrointestinal endoscopy not administered by anesthesiologists 

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Annunci

The Over-The-Scope-Clip (OTSC) system is effective in the treatment of chronic esophagojejunal anastomotic leakage.

J Gastrointest Surg. 2012 Aug;16(8):1585-9. doi: 10.1007/s11605-012-1862-1. Epub 2012 Mar 7.

Galizia G, Napolitano V, Castellano P, Pinto M, Zamboli A, Schettino P, Orditura M, De Vita F, Mabilia A, Pezzullo A, Lieto E.

Source

Division of Surgical Oncology-“F. Magrassi-A. Lanzara” Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, c/o II Policlinico, Edificio 17, Via Pansini 5, 80131 Naples, Italy. gennaro.galizia@unina2.it

Abstract

INTRODUCTION:

Management of postoperative esophagojejunal anastomotic leakage after total gastrectomy represents a very challenging event. Surgical repair is difficult, and conservative treatment can predispose to more severe complications. Endoclips and self-expanding stents are useful endoscopic therapeutic options but present some drawbacks. The Over-The-Scope-Clip (OTSC) system has been shown to be appropriate to close acute small gastrointestinal perforations, but its use in the treatment of chronic leakage remains controversial.

CASE SERIES:

The present series reports three consecutive chronic esophagojejunal anastomotic leaks successfully treated with OTSC. In all cases, clip application was simple, safe and effective, without early and late complications.

DISCUSSION:

The OTSC system may represent a new therapeutic option in the management of postoperative esophagojejunal anastomotic leakage.