Suppr超能文献

胃和结肠病变内镜下黏膜下剥离术后使用圈套器和开合夹的新型闭合方法

New Closure Method Using Loop and Open-Close Clips after Endoscopic Submucosal Dissection of Stomach and Colon Lesions.

作者信息

Yoshida Akira, Kurumi Hiroki, Ikebuchi Yuichiro, Kawaguchi Koichiro, Yashima Kazuo, Kamitani Yu, Yasui Sho, Nakada Yusuke, Kanda Tsutomu, Takata Tomoaki, Isomoto Hajime

机构信息

Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Tottori 683-8504, Japan.

出版信息

J Clin Med. 2021 Jul 23;10(15):3260. doi: 10.3390/jcm10153260.

Abstract

Endoscopic submucosal dissection (ESD) and resection of stomach and colon tumors have become common. However, mucosal defects resulting from ESD may cause delayed bleeding and perforation. To prevent adverse events, we developed a new clip closure technique, namely, the loop and open-close clip closure method (LOCCM), and aimed to examine its efficacy after ESD for stomach and colon tumors. The LOCCM uses loop and open-close clips. Here, the open-close clip was used to grasp the loop to bring it to the edge of the post-ESD mucosal defect. Another clip with a loop was then inserted into the opposite edge and clipped to the contralateral mucosa to pull both edges together. Once apposed, additional clips facilitated complete closure. The LOCCM was performed in 19 patients after ESD at Tottori University between October 2020 and March 2021. The outcomes retrospectively analyzed were the LOCCM success and adverse event rates. The complete closure rate using LOCCM was 89.5% and none of the patients had post-ESD bleeding or perforation. The results show that LOCCM is an effective and safe closure technique for mucosal defects after stomach and colon ESD to prevent bleeding and perforation.

摘要

内镜黏膜下剥离术(ESD)以及胃和结肠肿瘤切除术已变得很常见。然而,ESD导致的黏膜缺损可能会引起延迟性出血和穿孔。为预防不良事件,我们开发了一种新的夹子闭合技术,即环行开合夹子闭合法(LOCCM),并旨在研究其用于胃和结肠肿瘤ESD术后的疗效。LOCCM使用环行夹子和开合夹子。在此,开合夹子用于抓住环行夹子,将其拉至ESD术后黏膜缺损边缘。然后将另一个带环行的夹子插入相对边缘,并夹在对侧黏膜上,将两边拉拢。一旦对合,额外的夹子有助于实现完全闭合。2020年10月至2021年3月期间,鸟取大学对19例患者在ESD术后实施了LOCCM。回顾性分析的结果是LOCCM的成功率和不良事件发生率。使用LOCCM的完全闭合率为89.5%,且无一例患者发生ESD术后出血或穿孔。结果表明,LOCCM是一种用于胃和结肠ESD术后黏膜缺损的有效且安全的闭合技术,可预防出血和穿孔。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18b8/8348124/a565689d62c0/jcm-10-03260-g001.jpg

相似文献

2
Closure with clips to accelerate healing of mucosal defects caused by colorectal endoscopic submucosal dissection.
Surg Endosc. 2016 Oct;30(10):4438-44. doi: 10.1007/s00464-016-4763-7. Epub 2016 Feb 19.
4
Prophylactic clipping using the over-the-scope clip (OTSC) system after complex ESD and EMR of large colon polyps.
Surg Endosc. 2023 Oct;37(10):7520-7529. doi: 10.1007/s00464-023-10235-2. Epub 2023 Jul 7.
5
Clip-on-clip closure method for a mucosal defect after colorectal endoscopic submucosal dissection: a prospective feasibility study.
Surg Endosc. 2020 Mar;34(3):1412-1416. doi: 10.1007/s00464-019-07195-x. Epub 2019 Oct 16.
8
AGA Institute Clinical Practice Update: Endoscopic Submucosal Dissection in the United States.
Clin Gastroenterol Hepatol. 2019 Jan;17(1):16-25.e1. doi: 10.1016/j.cgh.2018.07.041. Epub 2018 Aug 2.
10
Closure of Mucosal Defects Using Endoscopic Suturing Following Endoscopic Submucosal Dissection: A Single-Center Experience.
Tech Innov Gastrointest Endosc. 2023;25(1):46-51. doi: 10.1016/j.tige.2022.11.002. Epub 2022 Nov 12.

本文引用的文献

1
Effect of anticoagulants on the risk of delayed bleeding after colorectal endoscopic submucosal dissection.
Endosc Int Open. 2020 Nov;8(11):E1654-E1663. doi: 10.1055/a-1244-2097. Epub 2020 Oct 22.
2
EMR/ESD: Techniques, Complications, and Evidence.
Curr Gastroenterol Rep. 2020 Jun 15;22(8):39. doi: 10.1007/s11894-020-00777-z.
3
Efficacy of mucosa-submucosa clip closure method after gastric endoscopic submucosal dissection.
World J Gastrointest Endosc. 2020 Jan 16;12(1):17-22. doi: 10.4253/wjge.v12.i1.17.
4
Clip-on-clip closure method for a mucosal defect after colorectal endoscopic submucosal dissection: a prospective feasibility study.
Surg Endosc. 2020 Mar;34(3):1412-1416. doi: 10.1007/s00464-019-07195-x. Epub 2019 Oct 16.
5
Clip Closure After Resection of Large Colorectal Lesions With Substantial Risk of Bleeding.
Gastroenterology. 2019 Nov;157(5):1213-1221.e4. doi: 10.1053/j.gastro.2019.07.037. Epub 2019 Jul 27.
8
Clinical impact of prophylactic clip closure of mucosal defects after colorectal endoscopic submucosal dissection.
Endosc Int Open. 2017 Dec;5(12):E1165-E1171. doi: 10.1055/s-0043-118743. Epub 2017 Nov 21.
9
Effects of antithrombotic therapy on bleeding after endoscopic submucosal dissection.
Gastrointest Endosc. 2017 Nov;86(5):807-816. doi: 10.1016/j.gie.2017.07.017. Epub 2017 Jul 19.
10

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验