ArticleSurgical endoscopy2018
Multicenter evaluation of first-line endoscopic treatment with the OTSC in acute non-variceal upper gastrointestinal bleeding and comparison with the Rockall cohort: the FLETRock study.
Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03065465 (Randomized Controlled Trial), which is not on this map. Cited by 26 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Randomized Controlled Trial (RCT) of Standard Endoscopic Hemostasis Compared to OVESCO for Severe Non-variceal UGI Hemorrhage
Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Clinical efficacy of the over-the-scope clip device: A systematic review.World journal of gastroenterology · 2020Pooled it
- Perforated and bleeding peptic ulcer: WSES guidelines.World journal of emergency surgery : WJES · 2020Guideline
- Clinical outcomes of over-the-scope-clip system for the treatment of acute upper non-variceal gastrointestinal bleeding: a systematic review and meta-analysis.BMC gastroenterology · 2019Pooled it
- Randomized Controlled Trial of Over-the-Scope Clip as Initial Treatment of Severe Nonvariceal Upper Gastrointestinal Bleeding.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2021Trial
- Endoscopic Management of Complex Duodenal Ulcer Bleeding Using Over-the-Scope Clips: Clinical Insights From a Regional Core Hospital.DEN open · 2026Article
- Application of "8"-loop traction-assisted duodenal endoscopic submucosal dissection and defect closure.Endoscopy · 2025Article
- Advancing hemostasis: A meta-analysis of novelWorld journal of gastrointestinal endoscopy · 2025Article
- Management of Refractory Bleeding at the Duodenal Bulb Post-Trauma Using OTSC Combined With Interventional Embolization: A Case Report.Clinical case reports · 2025Article
- Clinical landscape and treatment of acute non-variceal upper gastrointestinal bleeding: Insights from a high-volume center in Shaanxi, China.World journal of clinical cases · 2024Article
- Prophylactic clipping using the over-the-scope clip (OTSC) system after complex ESD and EMR of large colon polyps.Surgical endoscopy · 2023Article
- Reduced mortality for over-the-scope clips (OTSC) versus surgery for refractory peptic ulcer bleeding: a retrospective study.Surgical endoscopy · 2023Article
- Endoscopy in surgery.Frontiers in gastroenterology (Lausanne, Switzerland) · 2023Article
- Endoscopic hemostasis using an over-the-scope clip for massive bleeding after percutaneous endoscopic gastrostomy removal: a case report.Clinical endoscopy · 2022Article
- Hemostasis Techniques for Non-variceal Upper GI Hemorrhage: Beyond Injection and Cautery.Digestive diseases and sciences · 2022Review
- Over-the-Scope Clip Applications as First-Line Therapy in the Treatment of Upper Non-variceal Gastrointestinal Bleeding, Perforations, and Fistulas.Frontiers in medicine · 2022Article
- Over-the-scope clip versus transcatheter arterial embolization for refractory peptic ulcer bleeding-A propensity score matched analysis.United European gastroenterology journal · 2021Article
- Over-the-scope clip as first-line therapy for ulcers with high-risk bleeding stigmata is efficient compared to standard endoscopic therapy.Endoscopy international open · 2021Article
- Bleeding Duodenal Ulcer: Strategies in High-Risk Ulcers.Visceral medicine · 2021Review
- Simulation-Based Mastery Learning for Practicing Gastroenterologists-Renewed Importance in the Era of COVID-19.The American journal of gastroenterology · 2020Review
- Over-the-scope clip vs epinephrine with clip for first-line hemostasis in non-variceal upper gastrointestinal bleeding: a propensity score match analysis.Endoscopy international open · 2020Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe over-the-scope clip (OTSC) overcomes limitations of standard clips and achieves a more efficient and reliable hemostasis in non-variceal upper gastrointestinal bleeding (NVUGIB). The study aims to evaluate mortality, rebleeding, and mortality after rebleeding of patients in whom the OTSC was used as the first-line endoscopic treatment (FLET) of NVUGIB. PATIENTS AND
methodsIn total, 118 patients (FLET cohort) with a median age of 73.5 years (range 29-93 years; mean (±SD) 71.39 ± 12.39 years) were included. The distribution of patients with respect to risk category revealed a median Rockall score of 7 (range 3-10). For hypothesis testing, the FLET cohort was categorized into three risk groups taking into account the Rockall score: low risk [Rockall risk category (RRC ≤3)], moderate risk (RRC 4-7), and high risk (RRC ≥8). Event rates (mortality, rebleeding, and mortality after rebleeding) observed per risk group were compared to predicted event rates (Rockall cohort) using Fisher's Exact Test.
resultsPrimary successful hemostasis (PSH) was achieved in 92.4% either by FLET alone or in combination with an additional hemostasis technique in 1.7% (SCS = secondary clinical success). In 7.5% of the FLET cohort PSH could not be achieved. Compared to RRC prediction, mortality after rebleeding was significantly reduced from 27.9 to 10.9% in the high-risk group (RRC ≥8) treated with FLET (p < 0.011). Furthermore, the occurrence of rebleeding or continued bleeding was significantly lower in the moderate risk group (RRC 4-7) with 4.9% as well as in the high-risk group (RRC ≥8) with 21.4% compared to the Rockall cohort 24.0 and 53.2%, respectively (p < 0.001).
conclusionsThis study shows that OTSC is superior to standard care and FLET reduces significantly rebleeding and rebleeding-associated mortality in NVUGIB. For this reason, OTSC could be the treatment of choice as the first-line treatment as an alternative to standard hemostasis techniques in high-risk patients.
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Registered trials
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.