经内镜黏膜下剥离术和经内镜全层切除术入口部位缝合中传统夹闭与内镜下全覆膜金属夹的比较。
Conventional clips vs over-the-scope-clips for the closure of the entry site in POEM and G-POEM procedures.
机构信息
Endoscopia, Centro Médico Nacional Siglo XXI, Mexico.
Endoscopia, Centro Médico Nacional Siglo XXI, MEXICO.
出版信息
Rev Esp Enferm Dig. 2020 May;112(5):338-342. doi: 10.17235/reed.2020.6568/2019.
BACKGROUND
new alternatives for entry site closure (ESC) in per-oral endoscopy myotomy (POEM) and gastric peroral endoscopy myotomy (G-POEM) have appeared.
OBJECTIVE
to compare the over-the-scope-clip (OTSC®) and conventional clips (CC) for ESC in POEM and G-POEM.
MATERIAL AND METHODS
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.
RESULTS
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.
CONCLUSION
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.
背景
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。
目的
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。
材料和方法
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。
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）。
结论
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。
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