Zhang Yin, Fan Zhining, Wu Jie, Huang Xiaodan, Miao Lin, Wang Xiang
Department of Digestive Endoscopy, The First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital), Nanjing 210029, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2015 Feb;18(2):150-4.
To evaluate the efficacy of endoscopic purse-string suture (EPSS) with metallic clips and endoloop for the gastric wall defect after postoperative perforation.
Clinical data of 25 patients with gastric tumors(1 of gastric adenocarcinoma, 24 of gastric gastrointestinal stromal tumor, GIST) undergoing EPSS in Jiangsu Province People's Hospital and The Second Affiliated Hospital of Nanjing Medical University from January 2013 to May 2014 were retrospectively analyzed. During the procedure, EPSS was performed in 8 cases with perforation after endoscopic submucosal dissection(ESD), and in 17 cases with active perforation after endoscopic full-thickness resection.
Twenty-five patients underwent EPSS successfully. The procedure time was 35.0-75.0(49.8±10.1) min. No severe operational and postoperative complications occurred. Tumor resection margin were all negative. Time to withdraw gastrointestinal decompression drainage tube was 1-3(1.3±0.8) d. Postoperative hospital stay was 2-10(4.8±2.1) d and total cost was 10-31(19±0.5) thousand Yuan. One month after the procedure, all the patients received follow-up with no complaint of discomfort, and endoscopy confirmed that all the lesions healed.
EPSS with metallic clips and endoloop is effective and safe to close the gastric wall defect after full-thickness resection.
评估金属夹联合圈套器内镜荷包缝合术（EPSS）治疗术后胃穿孔所致胃壁缺损的疗效。
回顾性分析2013年1月至2014年5月在江苏省人民医院和南京医科大学第二附属医院接受EPSS治疗的25例胃肿瘤患者（胃腺癌1例，胃肠道间质瘤24例）的临床资料。术中，8例在内镜黏膜下剥离术（ESD）后穿孔患者及17例在内镜全层切除术后活动性穿孔患者接受了EPSS治疗。
25例患者均成功接受了EPSS治疗。手术时间为35.0 - 75.0（49.8±10.1）分钟。未发生严重手术及术后并发症。肿瘤切除切缘均为阴性。胃肠减压引流管拔除时间为1 - 3（1.3±0.8）天。术后住院时间为2 - 10（4.8±2.1）天，总费用为10 - 31（19±0.5）千元。术后1个月，所有患者均接受随访，无不适主诉，内镜检查证实所有病变均愈合。
金属夹联合圈套器EPSS治疗全层切除术后胃壁缺损有效且安全。
