Galloro Giuseppe, Zullo Angelo, Luglio Gaetano, Chini Alessia, Telesca Donato Alessandro, Maione Rosa, Pollastro Matteo, De Palma Giovanni Domenico, Manta Raffaele
Surgical Endoscopy Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Napoli, Italy.
Gastroenterology and Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Roma, Italy.
Clin Endosc. 2022 May;55(3):339-346. doi: 10.5946/ce.2021.249. Epub 2022 Apr 28.
Since the earliest reports, advanced clipping systems have been developed, and it is possible to choose among many models with different structural and technical features. The main drawback of through-the-scope clips is their small size, which allows the compression of limited amounts of tissue needed for large-size vessel treatment. Therefore, the over-the-scope clip system was realized, allowing a larger and stronger mechanical compression of large tissue areas, with excellent results in achieving a definitive hemostasis in difficult cases. Many studies have analyzed the indications and efficacy of two-pronged endoclips and have shown good results for initial and permanent hemostasis. The aim of this review was to provide updated information on indications, positioning techniques, and results of clip application for endoscopic treatment of upper gastrointestinal non-variceal bleeding lesions.
自最早的报道以来,先进的夹闭系统不断发展,现在可以在许多具有不同结构和技术特点的型号中进行选择。经内镜夹的主要缺点是其尺寸小,这使得在处理大尺寸血管时能够压缩的组织量有限。因此,出现了经内镜外夹系统,它能够对大面积组织进行更大且更强的机械性压迫,在处理困难病例时实现确切止血方面取得了优异效果。许多研究分析了双齿内镜夹的适应证和疗效,并显示在初始止血和永久性止血方面都有良好效果。本综述的目的是提供关于上消化道非静脉曲张性出血病变内镜治疗中夹闭应用的适应证、定位技术和结果的最新信息。