Closure and control of extraluminal collections and sepsis are usually required for gastrointestinal (GI) chronic perforations.
Covered self-expandable metal stents or plastic stents are an effective method in more than 80% of cases, but have many drawbacks.
Using the newly designed over-the-scope-clip (OTSC) initially intended for hemostasis of gastrointestinal bleeding to close two chronic inveterate external gastric fistulas, a research team from Italy reported the first successful closure of two gastro-cutaneous fistulas. Their study will be published on April 7, 2010 in the World Journal of Gastroenterology
They concluded that the OTSC may be the least invasive method to close chronic small fistulas or leaks, if prospective large comparative studies with fully-covered stents will confirm their observation.