Table 2. Endoscopic modalities for managing upper gastrointestinal defects.
Type of defect | Location | Preferred modality | Clinical success (%) | Reference |
---|---|---|---|---|
Perforation | Esophagus | TTSC (<1 cm) | 100%†,‡ | (45) |
OTSC (<2 cm) | 92–100 | (45,50) | ||
Suturing | >90% | (64) | ||
SEPS | 66–100% | (70-73) | ||
SEMS | 70–100% | (74-77) | ||
EVT | >90% | (45,78) | ||
Stomach | ||||
<1 cm | TTSC | 96–98% | (79-81) | |
1–2 cm | OTSC | 71–100% | (82,83) | |
Duodenum | ||||
Type 1 | Clips† | † | ||
Type 2 | TTS/OTSC | 80–90% | (84-86) | |
Type 3 | Surgery, biliary stent | — | ||
Fistula | TEF | |||
Malignant | FSEMS | >90% | (87) | |
Benign | FSEMS, SEPS | 76–90% | (88) | |
Gastrocutaneous/gastro-gastric | OTSC | 75–89% | (87,89,90) | |
Glue, mesh, tissue grafts†,‡ | ||||
Suturing | 40–80% | (64,88) | ||
Leak | Gastroesophageal | FSEMS +/− OTSC† | (64,91) | |
EVT | 78–94 | (68) | ||
Gastro-jejunal | OTSC, glue, sutures† | (67) |
†, limited data; ‡, case reports/case series/pooled analysis. TTSC, through-the-scope clip; OTSC, over-the-scope clip; SEPS, self-expandable plastic stent; FSEMS, fully-covered self-expandable metal stent; EVT, endoscopic vacuum therapy.