Division of Gastroenterology, Cleveland Clinic, London, UK.
Division of Gastroenterology, Cleveland Clinic, London, UK; Division of Surgery and Interventional Science, University College London, London, UK.
Best Pract Res Clin Gastroenterol. 2024 Jun;70:101915. doi: 10.1016/j.bpg.2024.101915. Epub 2024 May 4.
Gastrointestinal luminal defects, including perforations, leaks and fistulae, pose persistent obstacles in endoscopic therapeutic interventions. A variety of endoscopic approaches have been proposed, with through-the-scope clipping (TTSC), over-the-scope clipping (OTSC) and suturing representing the main techniques of tissue apposition. However, the heterogeneity in defect morphology, the technical particularities of different locations in the gastrointestinal (GI) tract and the impact of various parameters on the final outcome, do not allow distinct conclusions and recommendations on the optimal approaches for defect closure, and, thus, current practice is based on endoscopists experience and local availability of devices. This review aims to collect the existing evidence on tissue apposition devices, in order to outline the role of every device on specific indications.
胃肠道腔道缺损，包括穿孔、渗漏和瘘管，给内镜治疗干预带来持续的障碍。已经提出了多种内镜方法，其中经内镜夹闭（TTSC）、内镜下夹闭（OTSC）和缝合代表了组织贴合的主要技术。然而，缺陷形态的异质性、胃肠道（GI）不同部位的技术特殊性以及各种参数对最终结果的影响，不允许对缺损闭合的最佳方法得出明确的结论和建议，因此，目前的实践是基于内镜医生的经验和当地设备的可用性。本综述旨在收集现有的关于组织贴合设备的证据，以便概述每种设备在特定适应证中的作用。
