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OTSC Proctology clip as appropriate treatment for complicated anorectal fistula

  • RESEARCH
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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Evaluation of the effectiveness and tolerability of the application of an OTSC (Ovesco Endoscopy AG Tuebingen, Germany) Proctology clip as an innovative strategy of anorectal fistulae closure when established treatment strategies had already failed or were not feasible.

Methods

Retrospective single–center study including consecutive patients treated between March 2014 and March 2016 with the OTSC Proctology system for anorectal fistula closure, including one rectovaginal and one rectourethral fistula. The primary outcome was the healing rate with a minimum follow up of 6 months. Healing was defined as closure of the internal fistula ostium and absence of secretion or local inflammation during follow up.

Results

A total of 66 fistula closures by the OTSC Proctology clip were investigated, including cryptoglandular fistulas (45/66 patients, 68%), fistulas associated with CED (19/66 patients, 29%), and other non-cryptoglandular fistulas (2/66 patients, 4%). 47% (31/66 patients) had a failed previous therapy. In that selected collective, a successful fistula closure was achieved in 29/66 cases (44%) after a median follow up time of 40 months (6–61 months). Suprasphincteric and high transsphincteric fistulas showed healing in 63% and 42% in CD associated fistulas.

Conclusion

Fistula closure by the OTSC Proctology clip is an innovative, sphincter protecting treatment strategy in anorectal fistulas that can achieve long-term cure in complex anorecta

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Data availability

The data are available on request.

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Author notes

  1. Sabine Hannes and Maxim Kochergin contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Surgery and Coloproctology, DKD Helios Klinik Wiesbaden, Aukammallee 33, 65191, Wiesbaden, Germany

    Sabine Hannes, Maxim Kochergin, Jasmin Al-Haidary & Nils Habbe

  2. Institute for Clinical Oncological Research, North West Hospital, Frankfurt, Germany

    Thorsten Götze

Authors
  1. Sabine Hannes
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  2. Maxim Kochergin
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  3. Jasmin Al-Haidary
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  4. Thorsten Götze
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  5. Nils Habbe
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Contributions

The retrospective study was designed by Nils Habbe. Sabine Hannes and Maxim Kochergin contributed equally to this work and should be valued as shared first authors. Both acquired and analyzed the data. Sabine Hannes and Nils Habbe wrote the manuscript; Jasmin Al-Haidary, Thorsten Götze, and Nils Habbe reviewed it.

Corresponding author

Correspondence to Nils Habbe.

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Ethics approval

This study was performed in line with the principles of the 64th WMA General Assembly, Fortaleza, Brazil, October 2013. The study was approved by the regional ethics committee of the physician board Hessen (“Ethik-Kommission bei der Landesärztekammer Hessen”) (FF85/2018).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare no competing interests.

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Hannes, S., Kochergin, M., Al-Haidary, J. et al. OTSC Proctology clip as appropriate treatment for complicated anorectal fistula. Int J Colorectal Dis 38, 222 (2023). https://doi.org/10.1007/s00384-023-04516-4

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  • DOI: https://doi.org/10.1007/s00384-023-04516-4

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