Systematic Reviews
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2020; 26(24): 3495-3516
Published online Jun 28, 2020. doi: 10.3748/wjg.v26.i24.3495
Clinical efficacy of the over-the-scope clip device: A systematic review
Nicholas Bartell, Krystle Bittner, Vivek Kaul, Truptesh H Kothari, Shivangi Kothari
Nicholas Bartell, Krystle Bittner, Vivek Kaul, Truptesh H Kothari, Shivangi Kothari, Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, NY 14642, United States
Author contributions: Kothari S designed and conceptualized the study; Bartell N and Bittner K collected the data; all authors contributed with planning/conducting the study (literature review), interpretation of data, drafting/editing the manuscript, and approved the final draft.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Shivangi Kothari, FACG, FASGE, MD, Associate Professor, Division of Gastroenterology and Hepatology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 646, Rochester, NY 14642, United States.
Received: February 14, 2020
Peer-review started: February 14, 2020
First decision: April 22, 2020
Revised: May 19, 2020
Accepted: May 30, 2020
Article in press: May 30, 2020
Published online: June 28, 2020
Research background

The over-the-scope-clip (OTSC) device has become widely utilized in endoscopic practice. Limited data exist evaluating the overall clinical success and adverse event (AE) rates of OTSC across gastrointestinal (GI) indications.

Research motivation

The key significance of this systematic review is to provide endoscopists with a real-world estimate of the efficacy and safety of OTSC in clinical practice.

Research objectives

The aim of this study was to determine the rates of clinical success (CSR), technical success (TSR), AE and post-OTSC (salvage) surgery rates.

Research methods

A PubMed search was conducted for eligible articles describing the use of OTSC for any GI indication. Any article or case series reporting data for less than 5 total patients was excluded. Articles were included from January 1, 2007 to January 15, 2020. The following terms were used to perform the literature search: “over-the-scope-clip”, “OTSC”, “endoscopic fistula closure,” “over-the-scope clip bleeding”, “stent fixation”, and “endoscopic perforation closure.”

Research results

Eighty-five articles met inclusion criteria (n = 3025 patients). The overall CSR (inclusive of all indications) and TSR for OTSC placement was 78.4% (n = 2371/3025) and 94.4% (n = 2856/3025), respectively.

Research conclusions

OTSCs are a novel advancement in endoscopic practice. They are safe and effective for use in GI hemorrhage, anastomotic leak, perforation, defects created by endoscopic resection and stent fixation; however, there is room for improvement in use for fistula closure.

Research perspectives

Future large randomized control trials comparing OTSC with conventional and/or surgical interventions are needed to develop clinical guidelines for the most appropriate endoscopic application(s).