Observational studySurgical endoscopy2020
Endoscopic management of post-surgical GI wall defects with the overstitch endosuturing system: a single-center experience.
Observational study in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Endoscopic Treatment of Staple-Line Leaks After Sleeve Gastrectomy in Patients with Obesity: Which One is the Best Option, if Any? A Systematic Review with Meta-Analysis and Meta-regression.Obesity surgery · 2025Pooled it
- Interventional Endoscopy for the Management of Post-Surgical Leaks and Fistulas: A Scoping Review.Journal of clinical medicine · 2026Review
- Endoscopic Management of Post-Bariatric Surgery Complications: Diagnostic Work-Up and Innovative Approaches for Leak, Fistula, and Stricture Management.Diagnostics (Basel, Switzerland) · 2026Review
- Endoscopic treatment of gastrointestinal perforations and leaks: Why, when, and how?World journal of gastrointestinal endoscopy · 2026Review
- Current status of treatment for esophagojejunostomy leakage after total gastrectomy in patients with gastric cancer: a multicenter retrospective study in Korea.Journal of minimally invasive surgery · 2025Article
- Advancements in endoscopic closure techniques for gastrointestinal luminal defects comparative perspectives on OTSC, endo suturing, TTS clips, and X-Tack.Annals of medicine and surgery (2012) · 2025Review
- Reopenable clip over-the-line method in endoscopic full-thickness resection of gastric submucosal tumors: A historical control study.DEN open · 2025Article
- Endoscopic Intervention for Anastomotic Leakage After Gastrectomy.Journal of gastric cancer · 2024Review
- Successful Endoscopic Closure of Esophageal Perforation in Boerhaave Syndrome Using the Over-the-Scope Clip.GE Portuguese journal of gastroenterology · 2023Article
- Endoscopic Management of Postoperative Esophageal and Upper GI Defects-A Narrative Review.Medicina (Kaunas, Lithuania) · 2023Review
- Endoscopic submucosal dissection-based suture combined with medical adhesive for complicated tuberculous bronchoesophageal fistula: a case report.The Journal of international medical research · 2022Article
- Endoscopic Management of Bariatric Surgery Complications According to a Standardized Algorithm.Obesity surgery · 2021Article
- Endoscopic management of gastrointestinal leaks and fistulae: What option do we have?World journal of gastroenterology · 2020Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsPost-GI surgical wall defects are frequent and life-threatening complications, with limited literature regarding current treatment. This case series aims to assess the safety, feasibility, and outcomes of endoluminal therapy with the overstitch endoscopic suturing system (Apollo Endosurgery Inc, Austin). MATERIALS AND
methodsAll patients who underwent endoscopic suturing for post-surgical wall defect management at IRCCS-ISMETT Palermo from October 2017 until January 2019 were retrospectively enrolled. Stratification therapy was applied according to the clinical scenario, time from surgery to endoscopic intervention, and structural condition of the wall defect layers (tissue status and suture feasibility). The therapeutic endoscopic strategy was divided into three groups (A: pure endoscopic direct suture; B: combined therapy with endoscopic direct suture + FC-SEMS placement + anchoring; C: FC-SEMS placement + anchoring). Success was considered the resolution of symptoms and the presence of a regular intestinal transit after a period of 4-6 weeks.
resultsTwenty (20) patients (male/female 7/13; mean age 54 ± 13.43 years) were included in the study (group A: 9 patients, group B: 7 patients, group C: 4 patients). The types of operative procedures were bariatric (9/20), post-tracheostomy (3/20), post-operative GI surgery (8/20). The post-surgical defects were predominantly intermediate and chronic (24-72 h: 1/20; 3-30 days: 13/20; > 30 days: 6/20). The overall clinical success was 80% (17/20 patients), with a success of 94% (16/17 patients) when excluding the three cases of tracheo-esophageal fistula. No evidence of migration was detected. The only complication was short stenosis of the distal esophagus, present in 4 patients (19%) and successfully treated with a novel lumen-apposing metal stent.
conclusionsIn our experience, considering the absence of clear guidelines, the endoluminal approach with the overstich endoscopic suturing system is a valid alternative to conventional therapy, offering mini-invasiveness, and presenting promising opportunities in terms of technical feasibility and clinical efficacy.
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