Endoscopia, Centro Médico Nacional Siglo XXI, Mexico.
Endoscopia, Centro Médico Nacional Siglo XXI, MEXICO.
Rev Esp Enferm Dig. 2020 May;112(5):338-342. doi: 10.17235/reed.2020.6568/2019.
new alternatives for entry site closure (ESC) in per-oral endoscopy myotomy (POEM) and gastric peroral endoscopy myotomy (G-POEM) have appeared.
to compare the over-the-scope-clip (OTSC®) and conventional clips (CC) for ESC in POEM and G-POEM.
a retrospective review of a prospective POEM and G-POEM database was performed between January 2015 and August 2019. A description was made of outcomes, using either OTSC® or CC for submucosal tunnel closure.
forty-six POEM and 26 G-POEM were included in the study (23/13 per group [CC/OTSC®]). There were no clinical or procedure differences. ESC was performed with 1 OTSC® vs 5 CC and 1 vs 6 (p = 0.01) for POEM and G-POEM, respectively. Adverse events associated with clips were 21.7% vs 13% (p = 0.01) and 7.7% vs 0% (p = 0.02) for CC and OTSC® in POEM and G-POEM, respectively.
OTSC® represents a safe and effective alternative for entry site closure in POEM and G-POEM cases. Further studies are needed to recommend OTSC® as the first option for submucosal tunnel closure in these procedures.
经口内镜下肌切开术（POEM）和经口胃内镜下肌切开术（G-POEM）的新入路关闭（ESC）方法不断涌现。
比较经内镜隧道黏膜下切除术用钛夹（OTSC®）和传统夹（CC）用于 POEM 和 G-POEM 的 ESC。
回顾性分析了 2015 年 1 月至 2019 年 8 月间前瞻性 POEM 和 G-POEM 数据库，描述了使用 OTSC®或 CC 进行黏膜下隧道闭合的结果。
共纳入 46 例 POEM 和 26 例 G-POEM 患者（每组 23/13 例[CC/OTSC®]）。两组间临床或手术过程均无差异。POEM 和 G-POEM 中 ESC 分别使用 1 个 OTSC®和 5 个 CC，以及 1 个和 6 个 CC（p = 0.01）。CC 和 OTSC®相关的夹闭不良事件发生率分别为 21.7%和 13%（p = 0.01），7.7%和 0%（p = 0.02）。
OTSC®是 POEM 和 G-POEM 入路关闭的一种安全有效的替代方法。需要进一步的研究来推荐 OTSC®作为这些手术中黏膜下隧道闭合的首选方法。
