单腔与双腔内镜下闭合内镜黏膜下剥离术 相关创面或穿孔的疗效比较*

Different efficacy of single and double channel endoscopic closure for ESD related wound or perforation*

摘要:

摘要：目的 观察比较单腔内镜（SCE）与双腔内镜（DCE）下荷包缝合内镜黏膜下剥离术（ESD）相关手术创面或穿孔的临床效果。方法 胃黏膜或黏膜下肿块患者38例，随机分成A、B两组，并行ESD术。其中SCE组予以SCE下闭合创面或穿孔，DCE组予以DCE下闭合。结果 38例行ESD术后，创面或穿孔均予以SCE或DCE下尼龙绳成功闭合。结论 应用SCE或DCE下尼龙绳和钛夹成功闭合ESD创面或大穿孔，两者疗效相当，但SCE应用更加广泛。SCE有望取代DCE用于ESD创面或大穿孔的闭合，这为内镜下闭合大面积胃肠穿孔或ESD创面提供了新的途径。

Abstract:

Abstract: Objective Endoscopic submucosal dissection (ESD) is widely used for treatment of digestive diseases, perforation is a rare but lethal complication. The aim of this study was to clarify the efficacy and safety of single and double channel endoscopic closure for ESD related wound and perforation. Methods We analyzed the clinical data of 38 patients with ESD procedures. The patients were divided into 2 groups by random digits table. 20 ESD related wounds or perforations were closed under single channel endoscopy, while the other 18 were under double channel endoscopy. Results The 38 wounds and perforations were successfully managed with nylon loop pouch-suture through a single or double channel endoscope. Conclusions This is a randomized trial to verify that the efficacy of single and double channel endoscopic closure of ESD wounds or large perforations by using nylon loops and endoclips. Our successful experience proves that single channel endoscope could replace double channel endoscope on the closure of ESD wounds or large perforations which may provide a new approach for endoscopic closure of large gastrointestinal perforation or ESD wounds.