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Over-the-scope Clipping System Appears Viable for Endoscopic Removal
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PHILADELPHIA — Endoscopic resection of gastrointestinal tumors with the “over-the-scope clipping system” and cap-assisted technique was shown to be safe and effective, according to data presented at the ACG Annual Scientific Meeting.
The over-the-scope clipping system (OTSC) “has three components: a metal clip, a transparent cap and a handwheel system that all come together packaged into the device,” Shabnam Sarker, MD, of the department of gastroenterology at University of Alabama, said in a presentation. Using this device, a lesion is suctioned into the cap, the clip is released and then the lesion is resected above the clip using a hexagonal snare. “For our study, we wanted to evaluate the efficacy and safety of this method for the resection of these small GI tumors — submucosal lesions and, possibly, fibrotic lesions,” she said.
Sarker and colleagues performed a retrospective observational study of 28 patients (15 men; median age, 60 years) who had various types of GI lesions (mean size, 18 mm; range, 8-25 mm) removed with the OTSC-system at two facilities during a 2-year time period. Resected lesions included carcinoid or neuroendocrine tumor of the duodenum (n=6), rectum (n=7) or stomach (n=3), granular cell tumor of the esophagus (n=2), colon lesions (n=7), submucosal tumor of the stomach (n=1), GI stromal tumor of the stomach (n=1) or duodenum (n=1). Resection was technically successful in 92% of patients, and complete resection was achieved in 89% without related complications.
“We concluded that the OSCT-system can be a safe and feasible method for the resection of submucosal tumors and can also be used for possible fibrotic and complex mucosal lesions, though comparative studies are needed with routine [endoscopic mucosal resection] and [endoscopic submucosal dissection], and it would be useful to have prospective studies as well,” Sarker concluded.
For more information:
Sarker S. Abstract 23. Presented at: ACG Annual Scientific Meeting, Oct. 20-22, 2014; Philadelphia.
Disclosure: Relevant financial disclosures were not provided.