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

Saurabh Mukewar, Nitin Kumar, Marc Catalano, Christopher Thompson, Wasif Abidi, William Harmsen, Felicity T Enders, Christopher Gostout

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15 Scopus citations

Abstract

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.

Original languageEnglish (US)
JournalEndoscopy
DOIs
StateAccepted/In press - Jul 4 2016

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ASJC Scopus subject areas

  • Medicine(all)
  • Gastroenterology

Cite this

Mukewar, S., Kumar, N., Catalano, M., Thompson, C., Abidi, W., Harmsen, W., Enders, F. T., & Gostout, C. (Accepted/In press). Safety and efficacy of fistula closure by endoscopic suturing: a multi-center study. Endoscopy. https://doi.org/10.1055/s-0042-114036