PDF(Pubmed)
Abstract：
UNASSIGNED: Over-the-scope clips (OTSCs) are used for treating gastrointestinal perforations, postoperative anastomotic leakages, and mucosal defect closure after endoscopic resections. However, OTSCs are expensive and associated with fatal complications; therefore, proper OTSC usage is necessary. Criteria of OTSC use for mucosal defect closure after duodenal endoscopic submucosal dissection (ESD) are scarce. We examined closure outcomes with OTSCs and conventional clips in patients undergoing duodenal ESD, analyzed the resected specimen area, estimated the preoperative size of tumors treated with each method, and attempted to clarify the criteria for the use of OTSCs vs conventional clips.
UNASSIGNED: Endoscopic resection was performed for 133 superficial duodenal epithelial tumors from April 2017 to February 2022. Complete closure of mucosal defects after duodenal ESD was attempted for 82 superficial non-ampullary duodenal epithelial tumors, divided into OTSC and control (conventional clips used) groups. Closure outcomes were analyzed.
UNASSIGNED: The overall rate of complete mucosal defect closure in both groups was 98.8%. Significant between-group differences existed in the median estimated tumor size and median resected specimen area.
UNASSIGNED: Conventional clips work well for mucosal defects ≤18 mm after duodenal ESD, but for those >18 mm, a combination of OTSCs may be considered.
UNASSIGNED: Endoscopic resection was performed for 133 superficial duodenal epithelial tumors from April 2017 to February 2022. Complete closure of mucosal defects after duodenal ESD was attempted for 82 superficial non-ampullary duodenal epithelial tumors, divided into OTSC and control (conventional clips used) groups. Closure outcomes were analyzed.
UNASSIGNED: The overall rate of complete mucosal defect closure in both groups was 98.8%. Significant between-group differences existed in the median estimated tumor size and median resected specimen area.
UNASSIGNED: Conventional clips work well for mucosal defects ≤18 mm after duodenal ESD, but for those >18 mm, a combination of OTSCs may be considered.
摘要：
■镜外夹（OTSC）用于治疗胃肠道穿孔，术后吻合口漏,和内镜下切除后的粘膜缺损闭合。然而,OTSCs价格昂贵且与致命并发症有关；因此，正确使用OTSC是必要的。十二指肠内镜粘膜下剥离术（ESD）后OTSC用于粘膜缺损闭合的标准很少。我们检查了接受十二指肠ESD的患者使用OTSCs和常规夹子的闭合结果，分析切除的标本面积，估计每种方法治疗的肿瘤的术前大小，并试图阐明OTSCs与常规夹子的使用标准。
■于2017年4月至2022年2月对133例浅表十二指肠上皮肿瘤进行了内镜切除术。对82例浅表性非壶腹十二指肠上皮性肿瘤，尝试在十二指肠ESD后完全闭合粘膜缺损，分为OTSC和控制（使用常规剪辑）组。分析闭合结果。
■两组粘膜缺损完全闭合的总发生率为98.8%。中位估计肿瘤大小和中位切除标本面积存在显着组间差异。
■对于十二指肠ESD后≤18mm的粘膜缺损，常规夹子效果良好，但是对于那些>18毫米的，可以考虑OTSC的组合。
■于2017年4月至2022年2月对133例浅表十二指肠上皮肿瘤进行了内镜切除术。对82例浅表性非壶腹十二指肠上皮性肿瘤，尝试在十二指肠ESD后完全闭合粘膜缺损，分为OTSC和控制（使用常规剪辑）组。分析闭合结果。
■两组粘膜缺损完全闭合的总发生率为98.8%。中位估计肿瘤大小和中位切除标本面积存在显着组间差异。
■对于十二指肠ESD后≤18mm的粘膜缺损，常规夹子效果良好，但是对于那些>18毫米的，可以考虑OTSC的组合。
