Dinelli Marco, Omazzi Barbara, Andreozzi Paolo, Zucchini Nicola, Redaelli Alessandro, Manes Gianpiero
Gastroenterology and Endoscopy Unit, San Gerardo Hospital, Monza, Italy.
Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy.
Endosc Int Open. 2017 Mar;5(3):E151-E156. doi: 10.1055/s-0043-101692.
We describe our experience with a new over-the-scope clip (OTSC) system (Padlock Clip?) in the treatment of 14 patients. Eight of the 14 patients were treated for closure of gastrointestinal fistulas (n?=?4), iatrogenic gastrointestinal perforations (n?=?2), or hemostasis of post-polypectomy bleeding (n?=?2). The site of clipping was the lower gastrointestinal tract in five patients and the upper gastrointestinal tract in three patients. The clip was successfully delivered in seven out of the eight patients and clinical success was achieved in all patients. Endoscopic full thickness resection (EFTR) was performed to treat six patients: four with recurrent adenoma (n?=?4), one with ulcerated nodules at ileorectal anastomosis, and one with a neuro-endocrine tumor of the rectum. A complete intestinal wall resection was achieved in three of the six patients (50?%) and an R0 resection in five of the six patients (83.3?%). No complications related to the procedure and no recurrence at endoscopic follow-up were observed in any patient. The novel Padlock Clip seems to be an effective and safe tool to treat gastrointestinal fistulas, perforations or post-polypectomy bleeding, and to perform EFTR.
我们描述了使用一种新型套扎器（OTSC）系统（Padlock Clip？）治疗14例患者的经验。14例患者中，8例用于治疗胃肠道瘘管闭合（n = 4）、医源性胃肠道穿孔（n = 2）或息肉切除术后出血止血（n = 2）。套扎部位在5例患者为下消化道，3例患者为上消化道。8例患者中有7例成功放置了夹子，所有患者均取得了临床成功。对6例患者进行了内镜全层切除术（EFTR）：4例为复发性腺瘤（n = 4），1例在回直肠吻合处有溃疡结节，1例为直肠神经内分泌肿瘤。6例患者中有3例（50%）实现了完整的肠壁切除，6例患者中有5例（83.3%）实现了R0切除。所有患者均未观察到与手术相关的并发症，内镜随访也未发现复发。新型Padlock Clip似乎是治疗胃肠道瘘管、穿孔或息肉切除术后出血以及进行EFTR的一种有效且安全的工具。
