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. Oval-shape 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.
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. Oval-shape 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.
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Authors: Nicola de'Angelis; Salomone Di Saverio; Osvaldo Chiara; Massimo Sartelli; Aleix Martínez-Pérez; Franca Patrizi; Dieter G Weber; Luca Ansaloni; Walter Biffl; Offir Ben-Ishay; Miklosh Bala; Francesco Brunetti; Federica Gaiani; Solafah Abdalla; Aurelien Amiot; Hany Bahouth; Giorgio Bianchi; Daniel Casanova; Federico Coccolini; Raul Coimbra; Gian Luigi de'Angelis; Belinda De Simone; Gustavo P Fraga; Pietro Genova; Rao Ivatury; Jeffry L Kashuk; Andrew W Kirkpatrick; Yann Le Baleur; Fernando Machado; Gustavo M Machain; Ronald V Maier; Alain Chichom-Mefire; Riccardo Memeo; Carlos Mesquita; Juan Carlos Salamea Molina; Massimiliano Mutignani; Ramiro Manzano-Núñez; Carlos Ordoñez; Andrew B Peitzman; Bruno M Pereira; Edoardo Picetti; Michele Pisano; Juan Carlos Puyana; Sandro Rizoli; Mohammed Siddiqui; Iradj Sobhani; Richard P Ten Broek; Luigi Zorcolo; Maria Clotilde Carra; Yoram Kluger; Fausto Catena Journal: World J Emerg Surg Date: 2018-01-24 Impact factor: 5.469
Authors: Giacomo Emanuele Maria Rizzo; Giuseppina Ferro; Giovanna Rizzo; Giovanni Di Carlo; Alessandro Cantone; Gaetano Giuseppe Di Vita; Carmelo Sciumè Journal: Clin Endosc Date: 2021-06-07