Siddharthan Ragavan, Marcello Peter
Capitol District Colon and Rectal Surgery Associated, Albany, New York.
Department of Colon and Rectal Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts.
Clin Colon Rectal Surg. 2023 Jul 19;37(5):302-308. doi: 10.1055/s-0043-1770944. eCollection 2024 Sep.
Endoscopic closure is an essential technique to perform safe advanced endoscopy. Without appropriate closure of a defect, patients can experience spillage of fecal contents into the peritoneal cavity resulting in abdominal sepsis. The essential components to performing endoscopic closure are assessing the defect appropriately and choosing the correct closure technique. Assessing the defect involves five separate elements: timing, size, depth, shape, blood flow, and location in the colon or rectum. Understanding how each of these elements contributes toward a successful closure allows an endoscopist to choose the proper technique for closure. There have been many types of closure techniques described in the literature but the most common are through the scope clips, over the scope clips, and endoscopic suturing. There are advantages and disadvantages of each of these closure techniques. In this manuscript, we will discuss these common techniques as well as some additional techniques and the situations where they can be employed.
内镜闭合术是安全开展高级内镜检查的一项关键技术。若缺损未得到妥善闭合，患者可能会出现粪便内容物漏入腹腔，进而导致腹腔感染。实施内镜闭合术的关键要素包括正确评估缺损情况并选择合适的闭合技术。评估缺损涉及五个不同方面：时机、大小、深度、形状、血流情况以及在结肠或直肠中的位置。了解这些因素各自如何有助于成功闭合，能使内镜医师选择恰当的闭合技术。文献中描述了多种闭合技术，但最常见的是经内镜夹闭、内镜套扎夹闭和内镜缝合。每种闭合技术都有其优缺点。在本手稿中，我们将讨论这些常用技术以及一些其他技术和它们适用的情况。
