Evidence map›Paper›PMID 27633439›Full record

ArticleSurgical endoscopy2017

Outcome, comorbidity, hospitalization and 30-day mortality after closure of acute perforations and postoperative anastomotic leaks by the over-the-scope clip (OTSC) in an unselected cohort of patients.

M Raithel, H Albrecht, W Scheppach, M Farnbacher, W Haupt, A F Hagel, V Schellerer, F Vitali, M F Neurath, H T Schneider

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
5.0field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.

  1. Pooled it
  2. Boerhaave Syndrome-Narrative Review.Diagnostics (Basel, Switzerland) · 2025
    Review
  3. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

M RaithelDepartment of Medicine II, Gastroenterology and Interventional Endoscopy, Waldkrankenhaus St. Marien, Erlangen, Germany. martin.raithel@waldkrankenhaus.de.ORCID 0000-0001-7456-1079
H AlbrechtDepartment of Medicine 1, Gastroenterology, University Erlangen, Erlangen, Germany.
W ScheppachInternal Medicine and Gastroenterology, Julius-Spital, Würzburg, Germany.
M FarnbacherInternal Medicine and Gastroenterology, Clinics, Fürth, Germany.
W HauptSurgical Department, University Erlangen, Erlangen, Germany.
A F HagelDepartment of Medicine 1, Gastroenterology, University Erlangen, Erlangen, Germany.
V SchellererSurgical Department, University Erlangen, Erlangen, Germany.
F VitaliDepartment of Medicine 1, Gastroenterology, University Erlangen, Erlangen, Germany.
M F NeurathDepartment of Medicine 1, Gastroenterology, University Erlangen, Erlangen, Germany.
H T SchneiderInternal Medicine and Gastroenterology, Clinics, Fürth, Germany.
Friedrich-Alexander-Universität Erlangen-Nürnberg · DEKlinikum Fürth · DEMalteser Waldkrankenhaus Erlangen · DEStiftung Juliusspital · DEUniversitätsklinikum Erlangen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute gastrointestinal (GI) wall defects contain a high risk of morbidity and mortality and may be closed endoscopically by a full-thickness over-the-scope clip (OTSC).

methodsUnselected consecutive patients presenting with acute non-surgical perforations or postoperative anastomotic leaks or perforations underwent attempted OTSC placement as primary closure method after interdisciplinary consensus in three tertiary referral centres. Their clinical data and intervention characteristics were evaluated in an intention to treat analysis during a 24-month period to assess closure rates, 30-day mortality, hospitalization and comorbidity.

resultsIn total, 34 patients (16 females, 18 males, 69.5 years) were included with 22 non-surgical perforations and 12 postoperative anastomotic leaks or perforations. Definitive closure of the perforations and leaks was achieved in 26/34 patients (76.5 %). Successful closure of the GI wall defect resulted in a significantly shorter hospital stay (8 days, p = 0.03) and was significantly correlated with comorbidity (r = 0.56, p = 0.005). In the group with OTSC failure, hospitalization was 18 days and 6 of 8 patients (75 %) required immediate surgery. Three deaths occurred in the group with successful OTSC closure due to comorbidity, while one death in the OTSC failure group was related to a refractory perforation. Favourable indications and locations for a successful OTSC procedure were identified as PEG complications, endoscopic or postoperative leaks of stomach, colon or rectum, respectively.

conclusionsIn unselected patients, OTSC was effective for closure of acute GI wall defects in more than 75 % of all patients. Clinical success and short hospitalization were best achieved in patients without comorbidity, but closure of the perforation or the anastomotic leak was found to be not the only parameter relevant for patient outcome and mortality.

Indexed as

Acute DiseaseAdultAgedAged, 80 and overAnastomotic LeakComorbidityEndoscopy, GastrointestinalFemaleFollow-Up StudiesHospitalizationHumansIntention to Treat AnalysisIntestinal PerforationMaleMiddle AgedRetrospective StudiesEndoscopyGastrointestinal perforationOver-the-scope clip (OTSC)Perforation treatment

Identifiers

PMID27633439
OpenAlexW2518910890

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.