BACKGROUND Conventional endoscopic treatments can't control bleeding in as many as 20% of patients with non-variceal gastrointestinal (GI) bleeding. Recent studies have shown that over-the-scope-clip (OTSC) system allowed for effective hemostasis for refractory GI bleeding lesions. So we aimed to conduct a systematic review to evaluate the effectiveness and safety of the OTSC system for management of acute non-variceal upper GI bleeding. METHOD A comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane Library covering the period from January 2007 to May 2019. The literature was selected independently by two reviewers according to the inclusion and exclusion criteria. The statistical analysis was carried out using Comprehensive Meta-Analysis software version 3.0. RESULTS A total of 16 studies including 769 patients with 778 GI bleeding lesions were identified. Pooled technical success was achieved in 761 lesions [95.7%; 95% confidence interval (CI), 93.5-97.2%], and the pooled clinical success was achieved in 666 lesions (84.2, 95% CI, 77.4-89.2%). The incidence of re-bleeding was reported in 81 patients and the post-procedure mortality was 10.9% (n = 84). Only 2 (0.3%) patients occurred complications after OTSC system procedure. CONCLUSIONS Our study demonstrated that the OTSC system was a technically feasible modality and highly efficacious in achieving hemostasis in acute non-variceal upper gastrointestinal bleeding.

中文翻译：

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广角夹子系统治疗急性上非静脉曲张性胃肠道出血的临床疗效：系统评价和荟萃分析。

背景技术常规内窥镜治疗无法控制多达20％的非静脉曲张性胃肠道（GI）出血患者的出血。最近的研究表明，超视距夹子（OTSC）系统可对难治性胃肠道出血性病变进行有效止血。因此，我们旨在进行系统评价，以评估OTSC系统治疗急性非静脉曲张性上消化道出血的有效性和安全性。方法在2007年1月至2019年5月期间在PubMed，EMBASE和Cochrane图书馆进行了全面的文献检索。两名作者根据纳入和排除标准独立选择了文献。使用3.0版综合Meta-Analysis软件进行统计分析。结果共鉴定出16项研究，包括769例778 GI出血性病变的患者。在761个病灶中获得了综合技术成功[95.7％; 95％的置信区间（CI）为93.5-97.2％]，并且在666个病变中获得了合并的临床成功率（84.2、95％CI，77.4-89.2％）。据报道81例患者再出血的发生率，术后死亡率为10.9％（n = 84）。OTSC系统手术后仅2例（0.3％）发生并发症。结论我们的研究表明OTSC系统在技术上是可行的，并且在急性非静脉曲张上消化道出血止血方面非常有效。共有666个病变获得了综合临床成功（84.2、95％CI，77.4-89.2％）。据报道81例患者再出血的发生率，术后死亡率为10.9％（n = 84）。OTSC系统手术后仅2例（0.3％）患者发生了并发症。结论我们的研究表明OTSC系统在技术上是可行的，并且在急性非静脉曲张上消化道出血止血方面非常有效。在666个病灶中获得了综合的临床成功率（84.2，95％CI，77.4-89.2％）。据报道81例患者再出血的发生率，术后死亡率为10.9％（n = 84）。OTSC系统手术后仅2例（0.3％）患者发生了并发症。结论我们的研究表明OTSC系统在技术上是可行的，并且在急性非静脉曲张上消化道出血中达到止血效果非常有效。