Value of over-the-scope-clip for upper digestive tract perforation
10.3760/cma.j.issn.1007-5232.2017.11.008
- VernacularTitle:探讨内镜吻合夹在上消化道穿孔疾病中的应用价值
- Author:
Xiaoling ZHENG
1
;
Xiaoqiong CHEN
;
Liying GAO
;
Lixia XU
;
Haining LIN
;
Shishun ZHONG
;
Wanyin DENG
;
Jinhui ZHENG
;
Wei LIANG
Author Information
1. 福建省立医院消化内镜中心
- Keywords:
Esophageal perforation;
Endoscopy;
Anastomosis;
Therapy
- From:
Chinese Journal of Digestive Endoscopy
2017;34(11):791-795
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of OTSC( over-the-scope-clip) for upper digestive tract perforation. Methods Thirteen patients with old and fresh upper digestive tract perforation, treated with an OTSC clip at the Department of Digestive Endoscopy from May 2015 to June 2016, were enrolled. All OTSCs were 11/6t, and all procedures were performed by experienced endoscopists. Results Seven cases of fresh perforation were iatrogenic after treatment for gastric submucosal tumor. Six cases of old perforation included 2 cases of spontaneous esophageal rupture, 2 fistula after operations for esophageal foreign body, 1 fistula after the operation for gastric stromal tumor, and 1 anastomotic fistula after esophagectomy. Eight cases of perforation occurred in stomach and 5 in esophageal. Fresh lesion sizes were from 4 to 30 mm ( average 15. 3 mm), old lesion sizes from 5 to 10 mm(average 7. 8 mm). OTSC′s release time in fresh lesions was 6-27 min(average 15. 1 min), that in old 15-80 min(average 42. 3 min) with significant difference. Technical success rate was 100％(13/13),clinical success rate in fresh lesions was 100％(7/7),and 50％ (3/6) in old lesions. No patient had special treatment or complication. Conclusion OTSC is useful and safe for the treatment of upper digestive tract perforation, which is superior for fresh perforation than for the old. The perfect time to release OTSC for old perforation is when there is no obvious fibrosis caused by inflammation. The success rate is higher when the lesion size is smaller than 30 mm. Self-releasing of OTSC is rare. The necessity and the timing to take them out still needs further study.
