Zhang Wei, Sun Ge, Zhang Hang, Furnee Edgar, Liu Qizhi, Gong Haifeng, Sun Peichun, Zhang Wei
Department of Gastrointestinal Surgery, Henan Province People's Hospital, China.
Department of Colorectal Surgery, Changhai Hospital, Shanghai, China; Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Int J Surg Case Rep. 2021 Mar;80:105525. doi: 10.1016/j.ijscr.2021.01.019. Epub 2021 Jan 25.
Hemoclips have been used to protect leakage after endoscopic resection of large colorectal polyps or early-staged rectal cancer, or for perforation of the sigmoid colon during colonoscopy. However, endoscopic clips were seldom used to manage anastomotic leakage after low anterior resection of rectal cancer.
A patient with postoperative anastomotic leakage after low anterior resection for rectal cancer was successfully treated by endoscopic hemoclips under colonoscopic vision after failure of conservative treatment. Postoperative course was uncomplicated and the patient was discharged from the hospital seven days later.
Endoscopic hemoclips should be considered as an alternative option for the treatment of an anastomotic leakage in cases where conservative treatment has failed. As they are safe and effective for closure, however good bowel preparation and strict inclusion criteria are required.
止血夹已被用于在大肠大息肉或早期直肠癌内镜切除术后预防渗漏，或在结肠镜检查期间用于乙状结肠穿孔。然而，内镜夹很少用于直肠癌低位前切除术后吻合口漏的处理。
一名直肠癌低位前切除术后发生吻合口漏的患者，在保守治疗失败后，于结肠镜直视下通过内镜止血夹成功治疗。术后病程顺利，患者7天后出院。
在保守治疗失败的情况下，内镜止血夹应被视为治疗吻合口漏的一种替代选择。由于其闭合安全有效，但需要良好的肠道准备和严格的纳入标准。
