Shiomi Daijiro, Tanabe Mayo, Uragami Naoyuki, Toshimori Akiko, Kawamata Natsuki, Muraoka Mikio, Miyake Rei, Kure Masayoshi, Nakamura Hatsuka, Komagata Akinori, Kakazu Tomoaki, Kishi Yumi, Hayashi Takemasa, Ito Takayoshi, Yokoyama Noboru, Inoue Haruhiro
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan.
Digestive Diseases Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
Endosc Int Open. 2024 Oct 10;12(10):E1127-E1133. doi: 10.1055/a-2409-3622. eCollection 2024 Oct.
The MANTIS Clip (Boston Scientific) is a novel anchor pronged clip designed to enhance tissue grasping and facilitate the closure of defects in the gastrointestinal tract. This study evaluates the feasibility and effectiveness of the MANTIS Clip for closing mucosal defects following colorectal endoscopic submucosal dissection (C-ESD). A retrospective single-center study was conducted on patients who underwent C-ESD with MANTIS Clip closure from May 2023 to April 2024. The primary outcome measured was the complete closure success rate. Secondary outcomes included defect size, sustained closure rate, closure time, number of clips used, adverse events (AEs), and hospital stay duration. The MANTIS Clip was used in 52 cases. The complete closure rate was 98.1% (51/52), with a sustained closure rate of 96.1% (49/51). The median closed defect size was 32 mm, with the largest being 62 mm. The median closure time was 8 minutes. Typically, one MANTIS Clip per defect was used, with only one lesion requiring two clips. The median number of additional clips used was seven. AEs included one case of bleeding (1.9%) and one case of post-ESD coagulation syndrome (1.9%), both managed without extending hospital stays. The median C-reactive protein level on the first day post-ESD was 0.35 mg/dL and the median hospital stay was 5 days. The MANTIS Clip is effective and practical for mucosal defect closure post-C-ESD, demonstrating high success and sustained closure rates with minimal complications. Future multicenter randomized trials are needed to further assess its efficacy and safety.
MANTIS夹（波士顿科学公司）是一种新型的带锚定齿的夹子，旨在增强组织抓取能力并促进胃肠道缺损的闭合。本研究评估了MANTIS夹在结直肠内镜黏膜下剥离术（C-ESD）后闭合黏膜缺损的可行性和有效性。对2023年5月至2024年4月期间接受C-ESD并使用MANTIS夹闭合的患者进行了一项回顾性单中心研究。测量的主要结局是完全闭合成功率。次要结局包括缺损大小、持续闭合率、闭合时间、使用的夹子数量、不良事件（AE）和住院时间。共52例患者使用了MANTIS夹。完全闭合率为98.1%（51/52），持续闭合率为96.1%（49/51）。闭合缺损的中位数大小为32mm，最大为62mm。中位闭合时间为8分钟。通常每个缺损使用一个MANTIS夹，只有一个病变需要两个夹子。额外使用的夹子中位数为7个。不良事件包括1例出血（1.9%）和1例ESD后凝血综合征（1.9%），均未延长住院时间。ESD后第一天的C反应蛋白水平中位数为0.35mg/dL，中位住院时间为5天。MANTIS夹在C-ESD后闭合黏膜缺损方面有效且实用，显示出高成功率和持续闭合率，并发症极少。未来需要进行多中心随机试验以进一步评估其疗效和安全性。
