Chan Shannon Melissa, Auyeung Kitty Kit Ying, Lam Siu Fung, Chiu Philip Wai Yan, Teoh Anthony Yuen Bun
Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Dig Endosc. 2022 Jan;34(1):43-62. doi: 10.1111/den.14061. Epub 2021 Jul 19.
Recent advancement in endoscopic closure techniques have revolutionized the treatment of gastrointestinal perforations, leaks and fistulas. Traditionally, these have been managed surgically. The treatment strategy depends on the size and location of the defect, degree of contamination, presence of healthy surrounding tissues, patients' condition and the availability of expertise. One of the basic principles of management includes providing a barricade to the flow of luminal contents across the defect. This can be achieved with a wide range of endoscopic techniques. These include endoclips, stenting, suturing, tissue adhesives and glue, and endoscopic vacuum therapy. Each method has their distinct indications and shortcomings. Often, a combination of these techniques is required. Apart from endoscopic closure, drainage procedures by the interventional radiologist and surgical management also play an important role. In this review article, the outcomes of each of these endoscopic closure techniques in the literature is provided in tables, and practical management algorithms are being proposed.
内镜闭合技术的最新进展彻底改变了胃肠道穿孔、渗漏和瘘管的治疗方法。传统上，这些疾病都是通过手术治疗的。治疗策略取决于缺损的大小和位置、污染程度、周围健康组织的存在情况、患者的病情以及专业技术的可用性。治疗的基本原则之一是为管腔内容物穿过缺损提供一道屏障。这可以通过多种内镜技术来实现。这些技术包括内镜夹、支架置入、缝合、组织粘合剂和胶水，以及内镜真空治疗。每种方法都有其独特的适应症和缺点。通常，需要联合使用这些技术。除了内镜闭合外，介入放射科医生进行的引流程序和手术治疗也起着重要作用。在这篇综述文章中，这些内镜闭合技术在文献中的各自结果以表格形式呈现，并提出了实际的管理算法。
