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This article is a systematic review and meta-analysis that examines the success rates of different fixation techniques in preventing esophageal stent migration. The study analyzes various fixation techniques, including suturing and over-the-scope (OTS) clipping, and compares their effectiveness in preventing stent migration. The results of the analysis provide valuable insights into the performance of different fixation techniques and can inform clinical decision-making. The studies included in the analysis found that stent fixation significantly reduced the rate of stent migration compared to non-anchored stents, and the rates of adverse events were similar between the two groups. The study concludes that esophageal stent fixation is an effective treatment option for esophageal strictures, leaks, and fistulas, but more research is needed to determine the most appropriate technique. [Extracted from the article]

This article discusses the endoscopic closure of a refractory urethroanal fistula using an innovative wound closure device. Gastrointestinal (GI) fistulas are rare chronic diseases that can greatly impact a patient's quality of life. The endoscopic management of GI fistulas involves a combination of endoscopic submucosal dissection (ESD) and mechanical closure of the orifice. The authors report a case of a 29-year-old man with a refractory urethroanal fistula, and they successfully used a new flexible needle holder with a barbed suture to suture the edges of the fistula tract. This novel device allowed for effective closure in a tight area. The procedure was technically successful, with no adverse events reported. The authors suggest that this new needle holder could be added to the range of existing closure methods for gastrointestinal fistulas. [Extracted from the article]

Graph Introduction Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) result in mucosal defects of various sizes with exposure to muscularis and submucosal vessels; these defects can result in immediate or delayed adverse events, including bleeding and perforation. Location and indication for TTSS The most common indications for TTSS use were defect closure after lesion resection (n = 42, 79.2 %), followed by fistula closure (n = 7, 13.2 %) and stent fixation (n = 3, 5.7 %). For patients who underwent defect closure, TTSS showed excellent outcomes regardless of defect size. [Extracted from the article]

BACKGROUND : Although endoscopic vacuum therapy (EVT) has been successfully used to treat postoperative upper gastrointestinal (UGI) wall defects, its use demands special materials and several endoscopic treatment sessions. Herein, we propose a technical modification of EVT using a double tube (tube-in-tube drain) without polyurethane sponges for the drainage element. The tube-in-tube drainage device enables irrigation and application of suction. A flowchart for standardizing the management of postoperative UGI wall defects with this device is presented. METHODS : An EVT modification was made to achieve frequent fistula cleansing, with 3 % hydrogen peroxide rinsing, and the application of negative pressure. A tube-in-tube drain without polyurethane sponges can be inserted like a nasogastric tube or passed through a previously positioned surgical drain. This was a retrospective two-center observational study, with data collected from 30 consecutive patients. Technical success, clinical success, adverse events, time under therapy, interval time from procedure to fistula diagnosis and treatment start, size of transmural defect, volume of cavity, number of endoscopic treatment sessions, and mortality were reviewed. RESULTS : 30 patients with UGI wall defects were treated. The technical and clinical success rates were 100 % and 86.7 %, respectively. Three patients (10 %) had adverse events and three patients (10 %) died. The median time under therapy was of 19 days (range 1-70) and the median number of endoscopic sessions was 3 (range 1-9). CONCLUSIONS : This standardized approach and EVT modification using a tube-in-tube drain, with frequent fistula cleansing, were successful and safe in a wide variety of UGI wall defects. [ABSTRACT FROM AUTHOR]

This article describes a study conducted at the State University of Campinas in Brazil on the use of modified endoscopic vacuum therapy (EVT) for the treatment of gastrointestinal fistulas and perforations. The study included 32 patients who were treated with EVT using a low-cost customized nasogastric tube. The success rate of the treatment was 81.8%, with no complications or deaths reported. The study suggests that modified EVT is a safe and effective method for treating defects in the gastrointestinal tract, particularly postoperative fistulas. Further research is needed to confirm these findings. [Extracted from the article]

Background: Gastrointestinal (GI) fistula is a life-threatening condition and a therapeutic challenge. Endoscopic approaches include mucosal abrasion, clip closure, or stent diversion, with moderate success rates in the long term. We assessed whether fistula endoscopic submucosal dissection with clip closure (FESDC) could lead to complete resolution of fistulas even after failure of previous endoscopic therapy.Methods: Patients with GI fistulas, including those with previous failed treatment, were retrospectively included. The primary outcome was long-term (> 3 months) success of fistula healing. Secondary outcomes included technical success, safety, and factors associated with FESDC success.Results: 23 patients (13 refractory 57 %) were included. Tight immediate sealing was achieved in 19 patients (83 %; 95 % confidence interval [CI] 61 %-95 %). Long-term closure was achieved in 14 patients (61 %; 95 %CI 39 %-80 %), with median follow-up of 20 months. Complications occurred in two patients (9 %). Previous local malignancy (P = 0.08) and radiotherapy (P = 0.047) were associated with a higher risk of failure.Conclusion: This novel FESDC strategy was demonstrated to be safe and feasible for permanent endoscopic closure of GI fistulas. Further studies are warranted to determine the place of this technique in the management of chronic GI fistula. [ABSTRACT FROM AUTHOR]

5 After endoscopic negative pressure therapy with an open-pore film drain (OFD), the typical regular suction pattern of the open-pore drainage film can be seen in the shrinking wound canal. 3 An open-pore film drain (OFD) was inserted into the opening of the fistula canal. [Extracted from the article]

This article, published in the journal Endoscopy, discusses the use of an over-the-wire Lumen-Apposing Metal Stent (LAMS) for the management of a chronic fistula after One-Anastomosis Gastric Bypass surgery. The case study involves a 52-year-old female patient who experienced complications after surgery, including pouch staple line leakage. The LAMS was successfully placed to close the fistula, and follow-up scans showed complete closure. The patient was discharged the day after the procedure, and the LAMS was removed after one month. The article provides a video link for further information. [Extracted from the article]

This article discusses the occurrence and management of aerodigestive fistulas and leaks in lung cancer patients undergoing immunotherapy. The study analyzed the clinical and endoscopic data of nine patients who developed these complications after receiving chemo-immunotherapy for non-small cell lung cancer. The patients presented with esophageal leaks, distal airway fistulas, and proximal airway fistulas. Treatment involved the use of fully-covered stents and endobronchial valves, with a high success rate in resolving the leaks and fistulas. The article highlights the rare but life-threatening nature of these complications and emphasizes the importance of endoscopic interventions for improved outcomes. [Extracted from the article]

This article, published in the journal Endoscopy, discusses a surgical technique for treating colo-vaginal fistulae, a condition that can cause significant morbidity and mortality. The authors report on two cases of elderly women with diverticular disease who were referred to their center after experiencing faecaluria and pneumaturia. Due to the difficulty in identifying the colonic orifice of the fistula, the authors used a combined transvaginal and colonic rendez-vous approach. They inserted an ultrathin gastroscope into the vagina to locate the vaginal orifice, and then used a hydrophilic guidewire to guide a therapeutic gastroscope equipped with an over-the-scope clip for precise closure of the fistula. The authors conclude that this technique is an effective and feasible treatment option for colo-vaginal fistulae. [Extracted from the article]

This article, titled "Endoscopic closure of malignant coloduodenal fistula using Through The Scope Partially Covered Self Expanding Metal Stent with Stentfix," discusses a method for managing malignant coloduodenal fistula in patients who are not suitable candidates for surgery. The authors describe a case where a covered stent was used to close the fistula, and a stentfix was used to reinforce its position. This is the first reported case where a stentfix was used in conjunction with a stent when a therapeutic scope was not available. The article provides a video demonstrating the procedure. [Extracted from the article]

This article, published in the journal Endoscopy, discusses the contribution of colonoscopy in patients with isolated perianal fistula. The study aims to determine the prevalence and types of ileocolic lesions in these patients. The retrospective study included 68 patients who underwent colonoscopy at a hospital in Sfax over a six-year period. The results showed that chronic diarrhea, rectal bleeding, and weight loss were observed in a percentage of cases. Colonoscopy identified lesions in 11.9% of patients, with colonic polyps being the most common finding. The presence of chronic diarrhea was significantly associated with Crohn's disease. The study suggests that clinicians should consider performing a colonoscopy in patients with isolated perianal fistula, especially if chronic diarrhea is present. [Extracted from the article]

This article, published in the journal Endoscopy, discusses the endoscopic management of an early-onset extensive tracheoesophageal fistula (TEF). TEF is an abnormal communication between the trachea and the esophagus, which can be congenital or acquired. The primary cause of acquired TEF is long-term intubation. The article presents a case study of a patient who developed TEF eight days after ventilator support. The authors successfully deployed a fully covered esophageal stent to cover the gap and inserted a nasogastric tube via the stent. The stent was fixed with a TTS clip. The article includes a video demonstrating the procedure. [Extracted from the article]

This article, titled "Ovesco clip closure of colo-vaginal fistula in diverticulitis," discusses a case study involving a 90-year-old female patient with a history of passing stool per vagina for one month and diverticulitis. The patient underwent various procedures, including colonoscopy and the introduction of an UGI scope per vagina to evaluate the fistula. After unsuccessful attempts with cyanoacrylate glue, the medical team decided to use Ovesco clip closure due to the patient's age and co-morbidities. The article includes a video demonstrating the procedure. [Extracted from the article]

This article discusses the successful closure of an H-type congenital esophagobronchial fistula in an adult using an Over-the-scope-Clip. The condition is rare and often goes undiagnosed, presenting as a chronic cough or recurrent pneumonia. The case study involves a 56-year-old female who underwent esophagoscopy and had the clip deployed over the fistula. Follow-up examinations showed no recurrence of symptoms and the clip remaining in place. This is believed to be the first report of a congenital esophagobronchial fistula successfully closed using this method. [Extracted from the article]

This article presents a case study of a 63-year-old male patient who developed a recto-urethral fistula after undergoing Robot-Assisted Radical Prostatectomy (RARP) for prostate cancer. The patient was treated using a novel endoscopic transrectal suturing technique, which involved using the Apollo OverStitch SxTM Endoscopic Suturing System to close the fistula. The procedure was successful, with no recurrence of symptoms during the 11-month observation period. The article concludes that while this technique showed positive results, further research is needed to determine its overall effectiveness. [Extracted from the article]

This article, published in the journal Endoscopy, discusses the endoscopic treatment of a rare condition called Mirizzi Syndrome (MS) in a 90-year-old male patient. The patient had cholecystobiliary (CB) and cholecystocolonic (CC) fistulas, which were causing recurrent biliary sepsis. The treatment involved using a digital cholangioscopy to remove a gallbladder stone and clear the fistula tract. A guidewire was then inserted through both fistulas, and a fully covered metal biliary stent was deployed to maintain the CB fistulous tract. Finally, a colonoscopy was performed to close the colonic orifice using an over the scope clip. The patient has remained asymptomatic for one year following the procedure. [Extracted from the article]

This article, published in the journal Endoscopy, discusses the case of a 47-year-old man with gastric outlet obstruction and a large gastrocolic fistula caused by transverse colon adenocarcinoma. The patient was experiencing vomiting and compromised nutritional status. Initially, treatment with a duodenal fully covered metal stent was unsuccessful, so a two-step approach was attempted. This involved a gastrojejunostomy with a lumen apposing metal stent to restore passage to the small bowel, followed by suturing of the gastric antrum to exclude the fistula. The patient experienced satisfactory clinical results, with resolution of vomiting and improved oral intake. [Extracted from the article]

This article, titled "Complete endoscopic debridement combined with partial gastric wall resection successfully treated refractory esophagogastric anastomotic fistula: First clinical practice," discusses the case of a 59-year-old male who developed an esophagogastric anastomotic fistula after undergoing surgery for cardia adenocarcinoma. Despite previous treatments, the patient's symptoms did not improve and he was unable to eat orally. The authors performed two rounds of endoscopic debridement combined with gastric wall resection, resulting in successful healing of the fistula. The patient's weight increased during the follow-up period, and 18 months later, endoscopy confirmed complete healing of the fistula. [Extracted from the article]

This article discusses the use of over-the-scope clips in the treatment of gastrocutaneous fistulas (GF) that occur after the removal of a percutaneous endoscopic gastrostomy (PEG) tube. The study analyzed data from a large tertiary center and found that over-the-scope clips were effective in closing persistent GF. The technical success rate was 97%, and the clinical success rate at both 30 and 90 days was 94%. The study concludes that over-the-scope clips are a safe and efficient technique for closing persistent GF. [Extracted from the article]

This article compares the efficacy and safety of using the Luso-Cor esophageal stent (LCES) versus conventional covered metallic stents (CS) for managing fistulas after bariatric surgery. The study involved 60 patients who underwent primarily endoscopic management of fistulas, with 13 patients receiving LCES and 47 patients receiving CS. The results showed that the LCES was highly effective in closing fistulas, with a trend for lower incidence of adverse events, fewer endoscopies, and shorter time until fistula closure compared to CS. However, larger multi-center studies are needed to confirm these findings. [Extracted from the article]

This article, published in the journal Endoscopy, discusses a case study of a 47-year-old male with a history of alcoholic pancreatitis and various complications. The patient developed a duodenal-cutaneous fistula, which was successfully managed using an atrial septal occluder device. The device was inserted through the fistula and deployed to close it. The patient's condition improved, and follow-up imaging showed no further leaks. The article provides a video link for further reference. [Extracted from the article]

Background: Treatment of anastomotic leakage in reconstruction after esophagectomy remains challenging. This report presents a new endoscopic filling method for persistent fistula after failure of conservative treatment of leakage caused by anastomotic insufficiency.Methods: 10 of 14 patients, in whom post-esophagectomy leakage had failed to resolve after 2 weeks of conservative treatment, underwent endoscopic filling with polyglycolic acid (PGA) sheet and fibrin glue into the anastomotic leakage site, using a delivery tube and endoscopic catheter, respectively.Results: Each patient underwent jejunostomy, to secure nutrition. The leakage was resolved in all 10 patients. The mean number of PGA - fibrin glue procedures was 1.7. The mean period from the first application to the resumption of oral intake was 31.6 days, from the final application it was 14.7 days.Conclusions: The reported filling method offers a new endoscopic approach for persistent fistula after esophagectomy when conservative treatment of leakage has failed. [ABSTRACT FROM AUTHOR]

This article discusses three novel methods for closing complex gastrointestinal fistulas that are difficult to treat using traditional surgical, medical, or endoscopic techniques. The first method, developed by Li et al. from China, involves using cardiologic devices and coils to successfully close thoracogastric airway fistulas. De Cristofaro et al. from France were able to close a chronic rectovaginal fistula using principles of plastic surgery and a loop device called MARCEAU. Lafeuille et al. used a combination of endoscopic submucosal dissection and a flexible needle-holder with a barbed suture to close a refractory urethroanal fistula. These cases demonstrate the importance of thinking outside the box and importing tools and techniques from other disciplines to expand the horizons of therapeutic endoscopy. [Extracted from the article]

A 78-year-old man developed a late fistula between the gastroplasty pouch and right bronchus following Ivor Lewis esophagectomy for esophageal neoplasia (Fig. To extract the fistula from the wall, traction was applied to the mucosal flap using the clip-with-line traction technique, enabling deeper dissection of the fistula tract. [Extracted from the article]

Although challenging, if perforation and fistula are diagnosed, endoscopists should consider not only stent removal [2] but also immediate pancreatic drainage across the perforated site as a rescue treatment. B Video 1 b Endoscopic rescue technique for management of pancreatic perforation and fistula caused by placement of a pancreatic spontaneous dislodgement stent. [Extracted from the article]

This is the first report discussing EUS-CDS without fistula dilation using a FCSEMS with a 5.9-Fr delivery system, which is the thinnest ever commercially available delivery system and is capable of simpler and safer EUS-CDS procedures. B Video 1 b The video shows an endoscopic ultrasonography-guided choledochoduodenostomy without fistula dilation performed using a novel fully covered self-expandable metal stent with a 5.9-Fr ultra-thin delivery system. [Extracted from the article]

3 Colonoscopy 4 months after fistula closure revealed a cecal - sigmoid fistula as observed from: a the sigmoid colon; b the cecum. c Elective colonography confirmed a cecal - sigmoid fistula of 4 mm in diameter, meaning a 10.8-mm endoscope could no longer be passed through it. In recent years, endoscopic purse-string sutures and endoscopic closure using over-the-scope clips (OTSCs) have been applied not only to massive gastrointestinal perforations during endoscopic submucosal dissection, but also to intestinal fistulas, enterocutaneous fistulas, and gastrogastric fistulas, among others [3][4][5]. Asymptomatic internal fistulas can be followed up, but for patients with Crohn's disease who have symptomatic fistulas, such as the one reported here, endoscopic fistula closure is a minimally invasive procedure and should be considered as a viable treatment option. [Extracted from the article]

We attempted stent exchange. b, c We cut through half of the plastic stent near the fistula using a loop cutter to make a new side hole in the plastic stent. Moreover, a safe stent exchange technique for reintervention of EUS-HGS before fistula completion has not yet been established for plastic stents. 4 Replacement of the stent. a The plastic stent was removed with alligator forceps. b-d A fully covered metal stent (8 mm × 8 cm) was then placed along the guidewire. [Extracted from the article]

A 20-mm lumen-apposing metal stent (LAMS; Hot AXIOS, Boston Scientific, Marlborough, Massachusetts, USA) and plastic pigtail stent were deployed through the posterior gastric wall. 2 Maldeployed lumen-apposing metal stent (arrows) and plastic pigtail stent. a, b X-ray. c Computed tomography scan. [Extracted from the article]

Competing Interests: The authors declare that they have no conflict of interest.

Competing Interests: The authors declare that they have no conflict of interest.

Competing Interests: The authors declare that they have no conflict of interest.

Competing Interests: The authors declare that they have no conflict of interest.

Competing Interests: The authors declare that they have no conflict of interest.

The second gastroscopy (POD 7) revealed an esophageal fistula with 1.0 cm mucosal defect at the lower esophagus (Fig. 2 The third and fourth gastroscopies. a The third gastroscopy showed that the residual cavity was obviously smaller than before drainage. b The fourth gastroscopy showed that the esophageal wounds near the cardia were almost healed. After entering the thoracic cavity through the esophageal fistula, the necrotic tissue was cleaned and a gastric tube was placed into the cavity for drainage through the esophageal mucosal defect (Fig. [Extracted from the article]

Endoscopic suturing devices can thus represent a useful tool, reducing the risk of stent migration and related complications within a single-session procedure [4][5]. Endoscopic treatment with self-expandable metal stents (SEMSs) is still a feasible and safe option in patients with poor performance status, but the risk of stent migration is not negligible [2]. [Extracted from the article]

1 Endoscopic views showing: a a gastro-gastric fistula between the gastric pouch and the excluded gastric remnant; b the fourth tack in position, with closure of the fistula having been achieved by tightening and ligation of the suture. Index endoscopy revealed a 4-cm gastric pouch, with two gastro-gastric fistulas between the gastric pouch and the excluded gastric remnant, one measuring 12 mm and the other 8 mm (Fig. [Extracted from the article]

PGA sheets and fibrin glue have been reported as useful for treating GI fistulas [3][4], but most reports describe successful closure in the upper GI tract; few have reported on lower GI fistulas. An 86-year-old man with a postappendectomy abscess and fistula was treated with antibiotics and percutaneous drainage for 5 weeks, but the fistula did not close (Fig. [Extracted from the article]

2 Making an open-pore film drain: a strip of the double-layered open-pore film is wrapped around the distal end of a small drain tube and fixed with a suture. The tissue of the fistula channel was sucked into the pores of the open-pore film. [Extracted from the article]

The authors declare that they have no conflict of interest. letter We read with great interest the article by de Lima et al. on the application of endoscopic vacuum therapy (EVT) to upper gastrointestinal perforations [1]. Comments on "Tube-in-tube endoscopic vacuum therapy for the closure of upper gastrointestinal fistulas, leaks, and perforations" Tube-in-tube endoscopic vacuum therapy for the closure of upper gastrointestinal fistulas, leaks, and perforations. [Extracted from the article]

2 a Choledochoduodenal fistula in the interior wall of the duodenal bulb. b Guidewire placement into the choledochoduodenal fistula using a duodenoscope. c Balloon dilation of the fistula. d Insertion of a SpyGlass DS device into the intrahepatic bile duct. e Placement of a plastic stent into the choledochoduodenal fistula using a duodenoscope. 3 Cholangiography images with duodenoscope. a A choledochoduodenal fistula. b Intrahepatic bile duct stones. c Balloon dilation of the choledochoduodenal fistula. d Insertion of a SpyGlass DS into the intrahepatic bile duct. e Crushing stones and debris with electrohydraulic lithotripsy (EHL). f Intrahepatic bile duct stones have been cleared using a SpyGlass DS with EHL. [Extracted from the article]