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Endoscopy 2016; 48(11): 1023-1028
DOI: 10.1055/s-0042-114036
Innovations and brief communication
© Georg Thieme Verlag KG Stuttgart · New York

Safety and efficacy of fistula closure by endoscopic suturing: a multi-center study

Saurabh Mukewar
1   Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
,
Nitin Kumar
2   Brigham and Women’s Hospital, Boston, Massachusetts, USA
,
Marc Catalano
3   GI Associates, Milwaukee, Wisconsin, USA
,
Christopher Thompson
2   Brigham and Women’s Hospital, Boston, Massachusetts, USA
,
Wasif Abidi
2   Brigham and Women’s Hospital, Boston, Massachusetts, USA
,
William Harmsen
4   Department of Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
,
Felicity Enders
4   Department of Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
,
Christopher Gostout
1   Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
› Author Affiliations
Further Information

Publication History

submitted 14 November 2015

accepted after revision 04 July 2016

Publication Date:
30 August 2016 (online)

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Background and aim: Endoscopic closure of fistulas is desirable but remains a challenge, especially for gastrogastric fistulas. The aim of this study was to assess the success rate for the closure of gastrointestinal fistulas using an endoscopic suturing device.

Patients and methods: Electronic records at three medical centers were reviewed to identify patients who underwent sutured fistula closure as recorded on a central database. Demographic details, clinical variables, and details of the endoscopic procedure were recorded.

Results: A total of 56 patients (mean age 54 ± 12.7 years) underwent fistula closure. Gastrogastric fistulas were most common (n = 29; 51.8 %). Sixteen patients (28.6 %) had undergone previous failed attempts at closure. Immediate success was universal (n = 56; 100 %). Thirteen patients had persistent closure without any need for further therapies, while 17 underwent additional endoscopic procedures, with successful closure in 4 /17. Only one patient had abdominal pain requiring hospital admission.

Conclusion: Sutured closure of fistulas in a single session is safe and can be expected, even in what are known to be challenging cases. Sequential closure for recurrences is sometimes successful in the longer term.

 

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