Efficacy, Feasibility, and Safety of the X-Tack Endoscopic HeliX Tacking System: A Multicenter Experience.

Autor:	Canakis A; Department of Gastroenterology, University of Maryland Medical Center, Baltimore, MD., Dawod SM; Department of Gastroenterology, Weill Cornell Medical Center, New York, NY., Dawod E; Department of Gastroenterology, Weill Cornell Medical Center, New York, NY., Simons M; Department of Gastroenterology, Weill Cornell Medical Center, New York, NY., Di Cocco B; Department of Gastroenterology, Weill Cornell Medical Center, New York, NY., Westerveld DR; Department of Gastroenterology, Weill Cornell Medical Center, New York, NY., Trasolini RP; Department of Gastroenterology, Beth Israel Deaconess Medical Center, Boston., Berzin TM; Department of Gastroenterology, Beth Israel Deaconess Medical Center, Boston., Marshall CA; Department of Gastroenterology, UMass Memorial Medical Center, Worcester, MA., Abdelfattah AM; Department of Gastroenterology, UMass Memorial Medical Center, Worcester, MA., Marya NB; Department of Gastroenterology, UMass Memorial Medical Center, Worcester, MA., Smallfield GB; Department of Gastroenterology, Virginia Commonwealth University, Richmond, VA., Kaspar M; Department of Gastroenterology, Virginia Commonwealth University, Richmond, VA., Campos GM; Department of Gastroenterology, Virginia Commonwealth University, Richmond, VA., Skef W; Department of Gastroenterology, Loma Linda University Medical Center, Loma Linda, CA., Kedia P; Department of Gastroenterology, Methodist Dallas Medical Center, Dallas, TX., Smith TA; Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, TN., Aihara H; Department of Gastroenterology, Brigham and Women's Hospital., Moyer MT; Department of Gastroenterology, Penn State Health Milton S Hershey Medical Center. Hershey, PA., Sampath K; Department of Gastroenterology, Weill Cornell Medical Center, New York, NY., Mahadev S; Department of Gastroenterology, Weill Cornell Medical Center, New York, NY., Carr-Locke DL; Department of Gastroenterology, Weill Cornell Medical Center, New York, NY., Sharaiha RZ; Department of Gastroenterology, Weill Cornell Medical Center, New York, NY.
Jazyk:	angličtina
Zdroj:	Journal of clinical gastroenterology [J Clin Gastroenterol] 2024 Nov-Dec 01; Vol. 58 (10), pp. 1052-1057. Date of Electronic Publication: 2024 Jan 29.
DOI:	10.1097/MCG.0000000000001977
Abstrakt:	Background and Aims: The application of endoscopic suturing has revolutionized defect closures. Conventional over-the-scope suturing necessitates removal of the scope, placement of the device, and reinsertion. A single channel, single sequence, through-the-scope suturing device has been developed to improve this process. This study aims to describe the efficacy, feasibility, and safety of a through-the-scope suturing device for gastrointestinal defect closure. Methods: This was a retrospective multicenter study involving 9 centers of consecutive adult patients who underwent suturing using the X-Tack Endoscopic HeliX Tacking System (Apollo Endosurgery). The primary outcomes were technical success and long-term clinical success. Secondary outcomes included adverse events, recurrence, and reintervention rates. Results: In all, 56 patients (mean age 53.8, 33 women) were included. Suturing indications included fistula repair (n=22), leak repair (n=7), polypectomy defect closure (n=12), peroral endoscopic myotomy (POEM) site closure (n=7), perforation repair (n=6), and ulcers (n=2). Patients were followed at a mean duration of 74 days. Overall technical and long-term clinical success rates were 92.9% and 75%, respectively. Both technical and clinical success rates were 100% for polypectomies, POEM-site closures, and ulcers. Success rates were lower for the repair of fistulas (95.5% technical, 54.5% clinical), leaks (57.1%, 28.6%), and perforations (100%, 66.7%). No immediate adverse events were noted. Conclusion: This novel, through-the-scope endoscopic suturing system, is a safe and feasible method to repair defects that are ≤3 cm. The efficacy of this device may be better suited for superficial defects as opposed to full-thickness defects. Larger defects will need more sutures and probably a double closure technique to provide a reinforcement layer. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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