Minoda Yosuke, Ihara Eikichi, Ogino Haruei, Komori Keishi, Otsuka Yoshihiro, Ikeda Hiroko, Esaki Mitsuru, Chinen Takatoshi, Matsuguchi Takahiro, Takahashi Shunsuke, Shiga Noriko, Yoshimura Rie, Ogawa Yoshihiro
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Gastroenterology, Harasanshin General Hospital, Fukuoka, Japan.
Gastrointest Tumors. 2020 Apr;7(1-2):21-29. doi: 10.1159/000503994. Epub 2019 Nov 6.
BACKGROUND/AIMS: It is important to appropriately manage patients with procedure-related artificial mucosal ulcers or procedure-related complications. Many endoscopic closure techniques have been reported; however, they often require the use of special devices. We developed a single-channel endoscopic closure technique (SCCT) that can be performed with conventional devices. In the present study, we describe the technique and evaluate its efficacy.
Twenty-five consecutive patients who underwent endoscopic treatment and whose artificial ulcer was closed using the SCCT were enrolled in this study. The technical success rate, number of clips for closure, procedure time, complication rate on the day of the procedure, clinical success rates on days 1 and 5, and incidence of severe stenosis of the gastrointestinal (GI) tract at 2 months after the procedure were evaluated.
The median ulcer diameter was 20 mm. The tumor locations were the stomach ( = 19), jejunum ( = 1), and colon ( = 5). The technical success rate was 100% (25/25), and the rate of incomplete closure was 0% (0/25). Eight clips were needed on average. The median procedure time was 18 min (range 5-49 min). The complication rate was 0% (25/25). The clinical success rates on days 1 and 5 were 100% (19/19) and 100% (9/9), respectively. No patients presented stenosis as a late complication at 2 months after the procedure (0/25).
The SCCT could be applied in the treatment of artificial ulcers in several parts of the GI tract with a high clinical success rate and no complications. The SCCT appears to be a good option for closing artificial mucosal ulcers.
背景/目的：妥善处理与手术相关的人工黏膜溃疡或手术相关并发症患者至关重要。已有许多内镜闭合技术被报道；然而，这些技术通常需要使用特殊设备。我们开发了一种可使用传统设备进行的单通道内镜闭合技术（SCCT）。在本研究中，我们描述了该技术并评估其疗效。
本研究纳入了连续25例接受内镜治疗且人工溃疡通过SCCT闭合的患者。评估了技术成功率、闭合所需夹子数量、手术时间、手术当天的并发症发生率、术后第1天和第5天的临床成功率以及术后2个月时胃肠道严重狭窄的发生率。
溃疡中位直径为20mm。肿瘤位置分别为胃（19例）、空肠（1例）和结肠（5例）。技术成功率为100%（共25例，成功25例），闭合不全率为0%（共25例，无闭合不全）。平均需要8个夹子。中位手术时间为时长18分钟（范围5 - 49分钟）。并发症发生率为0%（共25例，无并发症）。术后第1天和第5天的临床成功率分别为100%（共19例，成功19例）和100%（共9例，成功9例）。术后2个月时无患者出现晚期并发症狭窄（共25例，无狭窄）。
SCCT可应用于胃肠道多个部位人工溃疡的治疗，临床成功率高且无并发症。SCCT似乎是闭合人工黏膜溃疡的一个良好选择。
