一种新颖的内镜缝合设备在内镜全层切除术后修补消化道缺损的初步应用（含视频）

Endoscopic suturing closure of gastrointestinal wall defect after endoscopic full-thickness resection （with video）

目的探讨利用一种新颖的内镜缝合设备（OverStitch^TM）修补内镜全层切除术（EFTR）后消化道缺损的临床疗效。方法回顾性分析应用OverStitch^TM设备缝合经EFTR治疗消化道黏膜下肿瘤后消化道缺损患者的临床资料，评价其有效性、可行性及安全性。结果共计5例患者，4例病灶位于胃部，1例病灶位于十二指肠降部，病灶大小2．0～5．0cm，平均3．2cm；患者均顺利完整切除病灶，完全修补缺损，修补时间11．0～22．0min，平均16．6min；住院时间4—6d，平均5d。2例患者术后第1天出现上腹部隐痛，体温升高症状，1例患者术后CT提示左侧胸腔少量积液，均予以半卧位休息，抗感染、制酸、胃肠减压治疗，3—4d后好转出院。结论OverStitch^TM作为一种新颖的内镜缝合技术，对于修补EFTR治疗后消化道缺损具有一定的可行性、有效性和安全性。

Objective To evaluate the efficacy of a new endoscopic suturing device（ OverStitchTM, Apollo Endosurgery, USA）for gastrointestinal wall defect after endoscopic full-thickness resection （EFTR）. Methods Clinical data of the patients with submucosal tumors who underwent endoscopic suturing closure of gastrointestinal wall defect at the Endoscopy Center of Zhongshan Hospital from April 2015 to June 2015 were retrospectively analyzed. Results Five patients were included in this research with 4 lesions located in stomach and 1 lesion located in descendent duodenum. The mean diameter of lesions was 3.2 cm （ ranging 2. 0- 5.0 cm）. All patients underwent complete closure and none of them was converted to laparoscopic surgery or laparotomy. The mean repairing time was 16. 6 min （ranging 11.0-22. 0 min）. The mean postoperative hospi- talization time was 5 days （ranging 4-6 d）. Two patients complained about slight abdominal pain and elevated body temperature. CT showed minor pleural effusion in one case. These patients received antibiotics, were on gastrointestinal decompression and asked to maintain the semi-supine position and discharged after 3 to 4 days. Conclusion Endoscopic suturing closure of gastrointestinal wall defect with the OverStitchTM endoscopic suturing device is technically fast, feasible and safe.