Combination of through-the-scope suturing and over-the-scope clips for closure of persistent gastrocutaneous fistula after gastrostomy tube removal (“X-lock technique”)

Q3 Medicine

VideoGIE Pub Date : 2025-10-01 DOI:10.1016/j.vgie.2025.05.004

Sagar Shah MD, Alireza Sedarat MD, Adarsh Thaker MD

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引用次数: 0

Abstract

Background and Aims

Persistent gastrocutaneous fistula (GCF) can occur after removal of gastrostomy tubes. Although surgical closure has historically been considered the most definitive treatment option, novel endoscopic devices have allowed for less-invasive closure techniques.

Methods

We present 2 cases in which closure of persistent GCF was performed using a combination of through-the-scope suturing and an over-the-scope clip (OTSC). In the first case, the suturing system and OTSC are used simultaneously, whereas in the second case, they are used sequentially.

Results

There were no immediate postprocedural adverse events after both procedures. Both patients resumed oral intake the day after the procedure was performed. The first patient has had no leakage from previous GCF for 2 months, and the second patient has not had recurrent leakage for over 12 months since closure.

Conclusions

Combination of through-the-scope suturing and OTSC placement is a viable treatment option for chronic GCF after gastrostomy tube removal.

查看原文本刊更多论文

经镜缝合与镜外夹联合治疗胃造瘘管拔除后持续性胃皮瘘（“X-lock技术”）

背景与目的切除胃造口管后可发生持续性胃皮瘘（GCF）。虽然手术封闭历来被认为是最明确的治疗选择，但新型内窥镜设备允许微创封闭技术。方法我们报告了2例使用镜内缝合和镜外夹（OTSC）联合闭合持续性GCF的病例。在第一种情况下，缝合系统和OTSC同时使用，而在第二种情况下，它们依次使用。结果两种手术均未发生术后立即不良事件。两名患者在手术后第二天恢复口服。第1例患者既往GCF 2个月无渗漏，第2例患者术后12个月无复发渗漏。结论经镜缝合联合OTSC放置是治疗胃造瘘管拔除后慢性GCF的可行方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.