Role of Cardiac Septal Occluders in the Treatment of Gastrointestinal Fistulas: A Systematic Review

Clinical Endoscopy

Christopher Thompson¹  Diogo Turiani Hourneaux De Moura¹  Pichamol Jirapinyo¹  Alberto Baptista²  Eduardo Guimarães Hourneaux De Moura³ 

[1] Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA;Hospital das Clínicas Caracas, Unidad de Exploraciones Digestivas, Caracas, Venezuela;Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil;

关键词: cardiac septal occluder;    endoscopy;    fistula;    gastrointestinal fistula;   

DOI  :  10.5946/ce.2019.030

来源: DOAJ

【 摘 要 】

Treating gastrointestinal (GI) fistulas endoscopically is challenging owing to an established epithelial tract. The variety of endoscopic approaches is transforming endoscopy into a first-line therapy. However, many sessions are often required, with variable success rates. Owing to these limitations, the off-label use of cardiac septal occluders (CSOs) has been reported. We searched for articles related to CSOs in the MEDLINE, EMBASE, Cochrane Library, and LILACS databases and gray literature. The primary outcomes included technical success, clinical success, and safety of CSOs in GI fistula management. A total of 25,574 records were identified, and 19 studies ultimately satisfied the inclusion criteria. Technical success was achieved in all cases. Of the 22 fistulas, 77.27% had successful closure, with a mean follow-up period of 32.02 weeks. The adverse event rate was 22.72%, with no associated mortality. Univariable and multivariable regression analyses showed no significant difference in the success of closure and adverse events in relation to several variables among the subgroups. The use of CSOs appeared to be technically feasible, effective, and safe in the treatment of GI fistulas. The satisfactory results derived from this sparse literature suggest that it can be an option in the management of GI fistulas.

【 授权许可】

Unknown