Gurwara Shelly, Clayton Steven
Section on Gastroenterology, Wake Forest Baptist Health Medical Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
Curr Gastroenterol Rep. 2019 Nov 20;21(11):57. doi: 10.1007/s11894-019-0730-5.
Esophageal perforations are associated with high morbidity and mortality. As opposed to surgical repair, endoscopic closure techniques have emerged over the years as a more minimally invasive approach for management. Our goal is to discuss different modalities for closure.
Through-the-scope clips (TTSCs), over-the-scope clips (OTSCs), and esophageal stent placement are well known options for closure. We will also discuss the more recent technique of endoscopic suturing for closure of larger defects as well as prevention of esophageal stent migration. For mediastinal collections associated with perforations, a more novel endoluminal vacuum therapy (EVT) for drainage may be an option. Overall, there are several different endoscopic options that can tailored to the specific features of an esophageal perforation. This review will discuss various techniques with which a gastroenterologist or thoracic surgeon should be familiar.
食管穿孔与高发病率和死亡率相关。与手术修复不同，多年来内镜闭合技术已成为一种更微创的治疗方法。我们的目标是讨论不同的闭合方式。
经内镜夹（TTSCs）、全层内镜夹（OTSCs）和食管支架置入是众所周知的闭合选择。我们还将讨论用于闭合较大缺损以及预防食管支架移位的最新内镜缝合技术。对于与穿孔相关的纵隔积液，一种更新颖的腔内负压治疗（EVT）引流可能是一种选择。总体而言，有几种不同的内镜选择可根据食管穿孔的具体特征进行调整。本综述将讨论胃肠病学家或胸外科医生应熟悉的各种技术。
