Singh Ritu Raj, Nussbaum Jeremy S, Kumta Nikhil A
Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Transl Gastroenterol Hepatol. 2018 Oct 31;3:85. doi: 10.21037/tgh.2018.10.09. eCollection 2018.
The endoscopic management armamentarium of gastrointestinal disruptions including perforations, leaks, and fistulas has slowly but steadily broadened in recent years. Previously limited to surgical or conservative medical management, innovations in advanced endoscopic techniques like natural orifice transluminal endoscopic surgery (NOTES) have paved the path towards development of endoscopic closure techniques. Early recognition of a gastrointestinal defect is the most important independent variable in determining successful endoscopic closure and patient outcome. Some devices including through the scope clips and stents have been well studied for other indications and have produced encouraging results in closure of gastrointestinal perforations, leaks and fistulas. Over the scope clips, endoscopic sutures, vacuum therapy, glue, and cardiac device occluders are other alternative techniques that can be employed for successful endoscopic closure.
近年来，用于胃肠道破裂（包括穿孔、渗漏和瘘管）的内镜治疗手段虽进展缓慢但稳步拓宽。以往局限于外科手术或保守药物治疗，诸如经自然腔道内镜手术（NOTES）等先进内镜技术的创新，为内镜闭合技术的发展铺平了道路。早期识别胃肠道缺损是决定内镜闭合成功及患者预后的最重要独立变量。包括经内镜夹和支架在内的一些器械已针对其他适应证展开了充分研究，并在胃肠道穿孔、渗漏和瘘管的闭合方面取得了令人鼓舞的结果。除内镜夹外，内镜缝合、负压治疗、胶水和心脏封堵器等是可用于成功内镜闭合的其他替代技术。
