Miwa Haruo, Sugimori Kazuya, Tsuchiya Hiromi, Sugimori Makoto, Nishimura Masaki, Tozuka Yuichiro, Komiyama Satoshi, Sato Takeshi, Kaneko Takashi, Numata Kazushi, Maeda Shin
Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.
Department of Gastroenterology Graduate School of Medicine, Yokohama City University Kanagawa Japan.
DEN Open. 2021 Sep 29;2(1):e51. doi: 10.1002/deo2.51. eCollection 2022 Apr.
Recently, a novel clip device, SureClip (Micro-Tech Co. Ltd., Nanjing, China), has been developed, which improved rotation and reopening performance. We aimed to assess the efficacy of the SureClip in prophylactic closure of the mucosal break after endoscopic papillectomy (EP) for ampullary neoplasm.
We retrospectively reviewed the medical records of 40 patients who underwent EP for ampullary neoplasms between October 2009 and March 2020. Prophylactic closure after resection was performed using the conventional clip between 2014 and 2018, and with the SureClip after 2019. The baseline characteristics, techniques, outcomes, and complications of EP were analyzed.
The median age of the patients (25 males and 15 females) was 70 years. The en block resection rate was 82.5% and the curative resection rate was 80.0%. Histologically, 11 (27.5%) patients had malignancy. Prophylactic closure was performed in 29 (72.5%) patients (17 conventional clips, 12 SureClip). Complications occurred in 18 (45.0%) patients, including postprocedure bleeding in 9 (22.5%) patients. However, no postprocedure bleeding was observed in the patients who received prophylactic closure using the SureClip ( = 0.038). All other factors were not significantly correlated with postprocedure bleeding. The duration of hospital stay after EP was significantly shorter in patients treated with the SureClip compared to those treated with a conventional clip or without clips ( < 0.05).
In the present study, prophylactic clipping of the mucosal break using the SureClip was effective in preventing bleeding after EP.
最近，一种新型夹子装置SureClip（中国南京微创医疗器械（集团）有限公司）已被研发出来，其旋转和重新打开性能得到了改进。我们旨在评估SureClip在内镜下壶腹肿瘤乳头切除术后（EP）预防性封闭黏膜破损的疗效。
我们回顾性分析了2009年10月至2020年3月期间接受壶腹肿瘤EP治疗的40例患者的病历。2014年至2018年使用传统夹子进行切除术后预防性封闭，2019年后使用SureClip。分析了EP的基线特征、技术、结果和并发症。
患者（25例男性和15例女性）的中位年龄为70岁。整块切除率为82.5%，根治性切除率为80.0%。组织学上，11例（27.5%）患者患有恶性肿瘤。29例（72.5%）患者进行了预防性封闭（17例使用传统夹子，12例使用SureClip）。18例（45.0%）患者发生并发症，包括9例（22.5%）患者术后出血。然而，使用SureClip进行预防性封闭的患者未观察到术后出血（P = 0.038）。所有其他因素与术后出血均无显著相关性。与使用传统夹子或未使用夹子治疗的患者相比，使用SureClip治疗的患者EP术后住院时间明显更短（P < 0.05）。
在本研究中，使用SureClip预防性夹闭黏膜破损对预防EP术后出血有效。
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