目的评估内镜闭合诊断性超声内镜相关十二指肠穿孔的安全性以及疗效。方法通过PubMed、Web of Science搜索引擎,以及国内万方、知网和维普数据库,以关键词检索国内外文献,纳入相关病例,加以综合分析。结果共纳入27例,均为女性,患者平均...目的评估内镜闭合诊断性超声内镜相关十二指肠穿孔的安全性以及疗效。方法通过PubMed、Web of Science搜索引擎,以及国内万方、知网和维普数据库,以关键词检索国内外文献,纳入相关病例,加以综合分析。结果共纳入27例,均为女性,患者平均年龄为74.6岁(范围54~93岁),穿孔部位多见于球降交界处(81.5%),其次为降部(4例,14.8%)以及降部与水平部交界处(1例,3.7%)。穿孔大小5~25 mm。27例患者中16例采用OTSC(over-the-scope-clips)吻合夹系统闭合,6例单纯采用金属夹闭合,4例采用金属夹联合尼龙绳行荷包闭合,1例放置全覆膜金属支架闭合,27例患者均成功闭合穿孔,未追加外科手术。结论内镜闭合诊断性超声内镜相关十二指肠穿孔是一种安全、可行且疗效确切的治疗方法,可有效的避免外科手术。展开更多
To demonstrate the clinical outcomes of a multicenter experience and to suggest guidelines for choosing a suction method.METHODSThis retrospective study at 5 medical centers involved 58 consecutive patients undergoing...To demonstrate the clinical outcomes of a multicenter experience and to suggest guidelines for choosing a suction method.METHODSThis retrospective study at 5 medical centers involved 58 consecutive patients undergoing over-the-scope clips (OTSCs) placement. The overall rates of technical success (TSR), clinical success (CSR), complications, and procedure time were analyzed as major outcomes. Subsequently, 56 patients, excluding two cases that used the Anchor device, were divided into two groups: 14 cases of simple suction (SS-group) and 42 cases using the Twin Grasper (TG-group). Secondary evaluation was performed to clarify the predictors of OTSC success.RESULTSThe TSR, CSR, complication rate, and median procedure time were 89.7%, 84.5%, 1.8%, and 8 (range 1-36) min, respectively, demonstrating good outcomes. However, significant differences were observed between the two groups in terms of the mean procedure time (5.9 min vs 14.1 min). The CSR of the SS- and TG-groups among cases with a maximum defect size ≤ 10 mm and immediate or acute refractory bleeding was 100%, which suggests that SS is a better method than TG in terms of time efficacy. The CSR in the SS-group (78.6%), despite the technical success of the SS method (TSR, 100%), tended to decrease due to delayed leakage compared to that in the TG-group (TSR, CSR; 88.1%), indicating that TG may be desirable for leaks and fistulae with defects of the entire layer.CONCLUSIONOTSC system is a safe and effective therapeutic option for gastrointestinal defects. Individualized selection of the suction method based on particular clinical conditions may contribute to the improvement of OTSC success.展开更多
文摘目的评估内镜闭合诊断性超声内镜相关十二指肠穿孔的安全性以及疗效。方法通过PubMed、Web of Science搜索引擎,以及国内万方、知网和维普数据库,以关键词检索国内外文献,纳入相关病例,加以综合分析。结果共纳入27例,均为女性,患者平均年龄为74.6岁(范围54~93岁),穿孔部位多见于球降交界处(81.5%),其次为降部(4例,14.8%)以及降部与水平部交界处(1例,3.7%)。穿孔大小5~25 mm。27例患者中16例采用OTSC(over-the-scope-clips)吻合夹系统闭合,6例单纯采用金属夹闭合,4例采用金属夹联合尼龙绳行荷包闭合,1例放置全覆膜金属支架闭合,27例患者均成功闭合穿孔,未追加外科手术。结论内镜闭合诊断性超声内镜相关十二指肠穿孔是一种安全、可行且疗效确切的治疗方法,可有效的避免外科手术。
文摘To demonstrate the clinical outcomes of a multicenter experience and to suggest guidelines for choosing a suction method.METHODSThis retrospective study at 5 medical centers involved 58 consecutive patients undergoing over-the-scope clips (OTSCs) placement. The overall rates of technical success (TSR), clinical success (CSR), complications, and procedure time were analyzed as major outcomes. Subsequently, 56 patients, excluding two cases that used the Anchor device, were divided into two groups: 14 cases of simple suction (SS-group) and 42 cases using the Twin Grasper (TG-group). Secondary evaluation was performed to clarify the predictors of OTSC success.RESULTSThe TSR, CSR, complication rate, and median procedure time were 89.7%, 84.5%, 1.8%, and 8 (range 1-36) min, respectively, demonstrating good outcomes. However, significant differences were observed between the two groups in terms of the mean procedure time (5.9 min vs 14.1 min). The CSR of the SS- and TG-groups among cases with a maximum defect size ≤ 10 mm and immediate or acute refractory bleeding was 100%, which suggests that SS is a better method than TG in terms of time efficacy. The CSR in the SS-group (78.6%), despite the technical success of the SS method (TSR, 100%), tended to decrease due to delayed leakage compared to that in the TG-group (TSR, CSR; 88.1%), indicating that TG may be desirable for leaks and fistulae with defects of the entire layer.CONCLUSIONOTSC system is a safe and effective therapeutic option for gastrointestinal defects. Individualized selection of the suction method based on particular clinical conditions may contribute to the improvement of OTSC success.
