Gastroenterology and Endoscopy Unit, S. Agostino Estense Civil Hospital, Modena, Italy.
Endoscopy. 2011 Jun;43(6):545-8. doi: 10.1055/s-0030-1256196. Epub 2011 Mar 15.
Gastrointestinal perforations and post-surgical fistulas are dreaded complications that dramatically increase morbidity and mortality. A new endoscopic over-the-scope clip (OTSC) system may be potentially useful for sealing visceral perforations in several clinical settings. We evaluated the advantages and clinical impact of the placement of OTSCs on the management of non-malignant gut leaks in 12 consecutive patients. OTSCs of 9.5 or 10.5 mm were used, according to the diameter of the defect within the wall. The indications for treatment were mainly related to post-surgical fistulas. Healing of the fistula was assessed by endoscopic or radiological means, and failed only once. No OTSC-related complications occurred. Endoscopic closure of perforations and post-surgical fistulas with the OTSC system is a simple and minimally invasive technique. This approach, when feasible, may be less expensive and more advantageous than a surgical approach.
胃肠道穿孔和术后瘘是令人畏惧的并发症，会显著增加发病率和死亡率。一种新的内镜下套扎器（OTSC）系统可能在多种临床情况下对封闭内脏穿孔具有潜在的作用。我们评估了在 12 例连续患者中使用 OTSC 处理非恶性肠道漏的优势和临床影响。根据壁内缺陷的直径，使用了 9.5 或 10.5mm 的 OTSC。治疗的适应症主要与术后瘘有关。通过内镜或影像学手段评估瘘的愈合情况，仅失败过一次。没有发生与 OTSC 相关的并发症。使用 OTSC 系统内镜闭合穿孔和术后瘘是一种简单且微创的技术。在可行的情况下，这种方法可能比手术方法更经济实惠且更具优势。
