Yoshida Naohisa, Hirose Ryohei, Dohi Osamu, Inagaki Yoshikazu, Murakami Takaaki, Inada Yutaka, Morimoto Yasutaka, Kobayashi Reo, Inoue Ken, Ghoneem Elsayed, Itoh Yoshito
Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Endoscopy. 2025 Apr;57(4):354-360. doi: 10.1055/a-2421-9767. Epub 2024 Sep 25.
The MANTIS Closure Device (MCD; Boston Scientific, Marlborough, Massachusetts, USA) is a reopenable clip with a sharp claw used for closure after endoscopic submucosal dissection (ESD). We evaluated the effectiveness of the MCD for fast and complete closure after colorectal ESD.Cases involving closure with the MCD after ESD of 20-60-mm colorectal lesions between April 2023 and January 2024 were reviewed. The primary end point was complete closure of the ESD defect with the MCD. Secondary end points included closure time, delayed bleeding, delayed perforation, and post-ESD coagulation syndrome (PECS). MCD application involved: 1) grasping the mucosa on the anal-side of the defect; 2) pushing the clip toward the oral-side mucosa and deploying it; 3) adding other reopenable clips for complete closure.61 cases involving MCD were analyzed. Mean tumor size was 32.3 (SD 9.2) mm. Complete closure rate was 98.4% and mean closure time was 6.9 (SD 2.6) minutes. The mean number of MCDs and other clips used was 1.0 (SD 0.1) and 4.7 (SD 1.4), respectively. Rates of delayed bleeding, delayed perforation, and PECS were 0%, 0%, and 9.8%, respectively.Fast and complete closure after colorectal ESD was successfully achieved using the MCD.
MANTIS闭合装置（MCD；美国波士顿科学公司，马萨诸塞州马尔伯勒）是一种可重新打开的夹子，带有锋利的爪，用于内镜黏膜下剥离术（ESD）后的闭合。我们评估了MCD在结直肠ESD后快速完全闭合的有效性。回顾了2023年4月至2024年1月期间20-60毫米结直肠病变ESD后使用MCD闭合的病例。主要终点是使用MCD完全闭合ESD缺损。次要终点包括闭合时间、延迟出血、延迟穿孔和ESD后凝血综合征（PECS）。MCD的应用包括：1）抓住缺损肛门侧的黏膜；2）将夹子推向口腔侧黏膜并展开；3）添加其他可重新打开的夹子以实现完全闭合。分析了61例使用MCD的病例。平均肿瘤大小为32.3（标准差9.2）毫米。完全闭合率为98.4%，平均闭合时间为6.9（标准差2.6）分钟。使用的MCD和其他夹子的平均数量分别为1.0（标准差0.1）和4.7（标准差1.4）。延迟出血、延迟穿孔和PECS的发生率分别为0%、0%和9.8%。使用MCD成功实现了结直肠ESD后的快速完全闭合。
