Novel treatment options for perforations of the upper gastrointestinal tract: Endoscopic vacuum therapy and over-the-scope clips

Table 1 Synopsis of studies reporting endoscopic vacuum therapy for upper gastrointestinal perforations n (%)

Ref.	Year	Overall (n)	Postoperative (n)	Other perforations (n)	Overall success	Complications	Mortality	Stenosis after completed therapy
Ahrens et al[13]	2010	5	5	0	5/5 (100)	0/5 (0)	1/5 (20)1	2/5 (40)
Brangewitz et al[55]	2013	32	30	2	27/32 (84)	0/32 (0)	5/32 (16)	3/32 (9)
Kuehn et al[29]	2012	9	5	4	8/9 (89)	0/9 (0)	1/9 (11)
Schorsch et al[3]	2013	24	17	7	23/24 (96)		1/24 (4)	1/18 (6)
Schniewind et al[54]	2013	17	17	0			2/17 (12)
Wedemeyer et al[56]	2010	8	8	0	7/8 (88)	0/8 (0)	0/8 (0)	1/8 (13)
Weidenhagen et al[30]	2010	6	6	0	6/6 (100)	0/6 (0)	1/6 (17)	1/6 (17)
Overall		101	88	13	76/84 (90)	0/60 (0)	11/101 (11)	8/69 (12)

¹One patient died during dilation of a stenosis after complete healing (aorto-esophageal fistula).

Table 2 Synopsis of studies reporting over-the-scope clip closure of gastrointestinal perforations n (%)

Ref.	Year	n	Overall success	Postoperative	Acute endoscopic and interventional perforations	Other chronic leaks and fistulas	Upper GI	Colorectal	Complications
Albert et al[33]	2011	12	8/12 (66)	5/6 (83)	2/2 (100)	1/4 (25)	7/9 (78)	1/3 (33)	0/12 (0)
Arezzo et al[34]	2012	14	12/14 (86)	12/14 (86)				12/14 (86)	0/14 (0)
Baron et al[35]	2012	36	24/36 (67)	10/14 (71)	4/5 (80)	10/17 (59)	19/27 (70)	5/9 (56)	2/36 (6)3
Jacobsen et al[36]	2012	10	5/10 (50)	5/10 (50)			5/9 (56)	0/1 (0)	0/10 (0)
Disibeyaz et al[37]	2012	9	5/9 (56)	4/7 (57)	1/1 (100)	0/1 (0)	4/8 (50)	1/1 (100)	0/9 (0)
Galizia et al[38]	2012	3	3/3 (100)	3/3 (100)			3/3 (100)		0/3 (0)
Gubler et al[39]	2012	14	13/14 (93)		13/14 (93)1		4/5 (80)	9/9 (100)1	0/14 (0)
Hagel et al[40]	2012	17	11/17 (65)	2/3 (67)	7/10 (70)	2/4 (50)	9/15 (60)	2/2 (100)2	0/17 (0)
Jayaraman et al[32]	2013	21	12/21 (57)						0/21 (0)
Kirschniak et al[11]	2007	4	4/4 (100)		4/4 (100)		1/1 (100)	3/3 (100)	0/4 (0)
Kirschniak et al[41]	2011	19	14/19 (74)	1/2 (50)	11/11 (100)	2/6 (33)	10/12 (83)	4/7 (57)	0/19 (0)
Manta et al[42]	2011	12	11/12 (92)	11/12 (92)			7/8 (88)	4/4 (100)	0/12 (0)
Mennigen et al[43]	2013	14	11/14 (79)	10/12 (83)		1/2 (50)	8/9 (89)	3/5 (60)	0/14 (0)
Mönkemüller et al[44]	2013	7	3/7 (43)	1/3 (33)		2/4 (50)	3/7 (43)		0/7 (0)
Nishiyama et al[45]	2013	13	11/13 (85)		7/8 (88)	4/5 (80)	7/9 (78)	4/4 (100)	0/13 (0)
Parodi et al[46]	2010	10	8/10 (80)	4/6 (67)	1/1 (100)	3/3 (100)	4/4 (100)	4/6 (67)	0/10 (0)
Pohl et al[47]	2010	2	1/2 (50)	1/2 (50)			1/2 (50)		0/2 (0)
Repici et al[48]	2009	2	2/2 (100)		2/2 (100)			2/2 (100)	0/2 (0)
Sandmann et al[49]	2011	10	9/10 (90)	2/3 (67)	3/3 (100)	4/4 (100)	7/8 (88)	2/2 (100)	0/10 (0)
Schlag et al[50]	2013	6	6/6 (100)		6/6 (100)		6/6 (100)		0/6 (0)
Seebach et al[51]	2010	7	5/7 (71)	2/3 (67)	3/4 (75)		1/2 (50)	4/5 (80)	0/7 (0)
Surace et al[52]	2011	19	8/19 (42)	7/18 (39)		1/1 (100)	7/15 (47)	1/4 (25)	0/19 (0)
Voermans et al[2]	2012	36	32/36 (89)	1/1 (100)	31/35 (89)		20/23 (87)	12/13 (92)	2/36 (6)4
Von Renteln et al[53]	2010	4	2/4 (50)	0/1 (0)		2/3 (67)	2/4 (50)		0/4 (0)
Overall		301	220/301 (73)	81/120 (68)	95/106 (90)b	32/54 (59)	135/186 (73)	73/94 (78)	4/301 (1.3)

^bP < 0.01 vs“postoperative” and “other chronic leaks and fistulas”.

¹Three patients underwent surgery, however, leak was found to be closed by over-the-scope clip (OTSC);

²One patient underwent surgery, however, leak was found to be closed by OTSC;

³ Unintended closure of small bowel lumen by OTSC in two cases;

⁴One esophageal perforation, one patient died after delayed operation of colonic perforation with OTSC detached.