PDF(Pubmed)
Abstract：
Treating gastrointestinal (GI) fistulas endoscopically is challenging owing to an established epithelial tract. The variety of endoscopic approaches is transforming endoscopy into a first-line therapy. However, many sessions are often required, with variable success rates. Owing to these limitations, the off-label use of cardiac septal occluders (CSOs) has been reported. We searched for articles related to CSOs in the MEDLINE, EMBASE, Cochrane Library, and LILACS databases and gray literature. The primary outcomes included technical success, clinical success, and safety of CSOs in GI fistula management. A total of 25,574 records were identified, and 19 studies ultimately satisfied the inclusion criteria. Technical success was achieved in all cases. Of the 22 fistulas, 77.27% had successful closure, with a mean follow-up period of 32.02 weeks. The adverse event rate was 22.72%, with no associated mortality. Univariable and multivariable regression analyses showed no significant difference in the success of closure and adverse events in relation to several variables among the subgroups. The use of CSOs appeared to be technically feasible, effective, and safe in the treatment of GI fistulas. The satisfactory results derived from this sparse literature suggest that it can be an option in the management of GI fistulas.
摘要：
由于已建立的上皮道，在内窥镜下治疗胃肠（GI）瘘具有挑战性。各种内窥镜方法正在将内窥镜转变为一线治疗。然而,经常需要许多会议，成功率可变。由于这些限制,已经报道了心脏间隔封堵器（CSO）的标签外使用。我们在MEDLINE中搜索了与CSO相关的文章，EMBASE,科克伦图书馆,和LILACS数据库和灰色文献。主要成果包括技术上的成功，临床成功，和CSO在胃肠道瘘管理中的安全性。共识别出25574条记录,19项研究最终满足纳入标准。在所有情况下都取得了技术成功。在22个瘘管中，77.27%成功关闭，平均随访期为32.02周。不良事件发生率为22.72%,没有相关的死亡率。单变量和多变量回归分析显示，亚组之间的几个变量在闭合成功率和不良事件方面没有显着差异。使用民间社会组织在技术上似乎是可行的，有效,在胃肠道瘘的治疗中也是安全的。从这些稀疏的文献中得出的令人满意的结果表明，它可以作为胃肠道瘘管理的一种选择。
