Role of endoscopic clipping in the treatment of oesophagealperforations

• 作者: aacute Gy n ouml r, Attila Paszt, Eszter M rgy L z
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: OESOPHAGEAL PERFORATION ENDOSCOPIC CLIPPING Upper GASTROINTESTINAL PERFORATION ENDOSCOPY Over-thescopeclip
• 年，卷（期）: 2016,（1）
• 页码范围: 13-22
• 页数: 10页
• 分类号: R

摘要

With advances in endoscopic technologies, endoscopicclips have been used widely and successfully in thetreatment of various types of oesophageal perforations,anastomosis leakages and fistulas. Our aim was tosummarize the experience with two types of clips Thethrough-the-scope （TTS） clip and the over-the-scopeclip （OTSC）. We summarized the results of oesophagealperforation closure with endoscopic clips. We processedthe data from 38 articles and 127 patients using PubMedsearch. Based on evidence thus far, it can be stated thatboth clips can be used in the treatment of early （〈 24h）, iatrogenic, spontaneous oesophageal perforationsin the case of limited injury or contamination. TTS clipsare efficacious in the treatment of 10 mm lesions, whilebigger （〈 20 mm） lesions can be treated successfullywith OTSC clips, whose effectiveness is similar to thatof surgical treatment. However, the clinical success rateis significantly lower in the case of fistulas and in thetreatment of anastomosis insufficiency. Tough prospectiverandomized multicentre trials, which produce the largestamount of evidence, are still missing. Based onexperience so far, endoscopic clips represent a possibletherapeutic alternative to surgery in the treatment ofoesophageal perforations under well-defined conditions.