AIM:To determine the outcome of the management of iatrogenic gastrointestinal tract perforations treated by over-the-scope clip(OTSC)placement.METHODS:We retrospectively enrolled 20 patients(13 female and 7 male;mean ...AIM:To determine the outcome of the management of iatrogenic gastrointestinal tract perforations treated by over-the-scope clip(OTSC)placement.METHODS:We retrospectively enrolled 20 patients(13 female and 7 male;mean age:70.6±9.8 years)in eight high-volume tertiary referral centers with upper or lower iatrogenic gastrointestinal tract perforation treated by OTSC placement.Gastrointestinal tract perforation could be with oval-shape or with round-shape.Ovalshape perforations were closed by OTSC only by suction and the round-shape by the"twin-grasper"plus suction.RESULTS:Main perforation diameter was 10.1±4.3 mm(range 3-18 mm).The technical success rate was 100%(20/20 patients)and the clinical success rate was 90%(18/20 patients).Two patients(10%)who did not have complete sealing of the defect underwent surgery.Based upon our observations we propose two types of perforation:Round-shape"type-1 perforation"and oval-shape"type-2 perforation".Eight(40%)out of the 20 patients had a type-1 perforation and 12 patients a type-2(60%).CONCLUSION:OTSC placement should be attempted after perforation occurring during diagnostic or therapeutic endoscopy.A failed closure attempt does not impair subsequent surgical treatment.展开更多
文摘AIM:To determine the outcome of the management of iatrogenic gastrointestinal tract perforations treated by over-the-scope clip(OTSC)placement.METHODS:We retrospectively enrolled 20 patients(13 female and 7 male;mean age:70.6±9.8 years)in eight high-volume tertiary referral centers with upper or lower iatrogenic gastrointestinal tract perforation treated by OTSC placement.Gastrointestinal tract perforation could be with oval-shape or with round-shape.Ovalshape perforations were closed by OTSC only by suction and the round-shape by the"twin-grasper"plus suction.RESULTS:Main perforation diameter was 10.1±4.3 mm(range 3-18 mm).The technical success rate was 100%(20/20 patients)and the clinical success rate was 90%(18/20 patients).Two patients(10%)who did not have complete sealing of the defect underwent surgery.Based upon our observations we propose two types of perforation:Round-shape"type-1 perforation"and oval-shape"type-2 perforation".Eight(40%)out of the 20 patients had a type-1 perforation and 12 patients a type-2(60%).CONCLUSION:OTSC placement should be attempted after perforation occurring during diagnostic or therapeutic endoscopy.A failed closure attempt does not impair subsequent surgical treatment.
