Eun Jun Young, Jung Yunho, Lee Tae Hoon, Cho Young Sin, Rhee Ho Sung, Jung Young Kyu, Han Joung-Ho, Kim Duk Su, Chung Il Kwun, Park Sang-Heum, Kim Sun Joo
Division of Gastroenterology, Department of Medicine, Soonchunhyang University College of Medicine, 23-20 Bongmyung-dong, Dongnam-gu, Cheonan-si, Chungcheongnam-do, South Korea.
Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, South Korea.
Dig Dis Sci. 2017 Apr;62(4):913-921. doi: 10.1007/s10620-017-4483-4. Epub 2017 Feb 8.
The incidence of iatrogenic colonic perforation has been gradually increasing. In particular, sigmoid colon perforations are difficult to handle because of excess mobility.
The aim of this study was to evaluate the efficacy of the twin grasper-clips technique for large perforations of the sigmoid colon.
This study was designed as a prospective, randomized, experimental study using ex vivo porcine colorectal specimens. Thirty standardized and variable artificial perforations were closed in the hemoclip group (hemoclips) and twin grasper group (hemoclips with a novel tissue grasper). We counted the number of hemoclips used per case to assess the cost and efficacy of the procedure.
In the hemoclip group (n = 15), among the 20-, 25-, and 30-mm defects, the mean number of clips (4.8 ± 0.8, 6.0 ± 1.6, and 8.4 ± 2.1, respectively, p = 0.011) and closure time (7.6 ± 0.5, 9.9 ± 3.3, and 13.9 ± 4.1 min, respectively, p = 0.020) differed significantly. In the twin grasper group (n = 15), among the 20-, 25-, and 30-mm defects, the mean number of clips (4.0 ± 1.0, 5.0 ± 0.7, and 5.4 ± 1.1, respectively, p = 0.101) and closure time (7.7 ± 0.6, 8.3 ± 1.9, and 9.1 ± 2.7 min, respectively, p = 0.506) did not differ significantly. In 30-mm defects, the mean number of hemoclips used per case and total closure time were significantly lower in the twin grasper group than the hemoclip group.
The twin grasper-clips technique seems to reduce the use of hemoclips and to result in more effective and rapid closure than does the conventional technique in large perforations of the ex vivo porcine sigmoid colon.
医源性结肠穿孔的发生率一直在逐渐上升。特别是乙状结肠穿孔，由于其活动度大，处理起来较为困难。
本研究旨在评估双抓钳夹技术治疗乙状结肠大穿孔的疗效。
本研究设计为一项前瞻性、随机、实验性研究，使用离体猪大肠标本。在血管夹组（血管夹）和双抓钳组（带有新型组织抓钳的血管夹）中，对30个标准化的不同大小人工穿孔进行闭合。我们计算每例使用的血管夹数量，以评估该操作的成本和疗效。
在血管夹组（n = 15）中，在20毫米、25毫米和30毫米的缺损中，平均血管夹数量（分别为4.8±0.8、6.0±1.6和8.4±2.1，p = 0.011）和闭合时间（分别为7.6±0.5、9.9±3.3和13.9±4.1分钟，p = 0.020）差异显著。在双抓钳组（n = 15）中，在20毫米、25毫米和30毫米的缺损中，平均血管夹数量（分别为4.0±1.0、5.0±0.7和5.4±1.1，p = 0.101）和闭合时间（分别为7.7±0.6、8.
