Closure of colonic deep mural injury and perforation with endoclips

Autor: Fernando Palacios Salas, Jorge Vásquez Quiroga, Lesly Sttefany Calixto Aguilar, Edgar Alva Alva, Luis Marin Calderón, Harold Benites Goñi, Jéssica Alférez Andía, Paulo Bardalez Cruz, Milagros Dávalos Moscol
Rok vydání: 2020
Předmět:
Zdroj: Revista Española de Enfermedades Digestivas. 112
ISSN: 1130-0108
DOI: 10.17235/reed.2020.6880/2020
Popis: Introduction colorectal perforations are one of the most feared complications after performing an endoscopic resection. The use of endoclips is considered for the management of these complications. Objectives to evaluate the efficacy and safety of the use of endoclips in the management of perforations and deep mural injuries that occur after an endoscopic colorectal resection. Methods a prospective cohort of consecutively included patients was used with a diagnosis of perforation or deep mural injury after an endoscopic colorectal resection treated with endoclips in our institution. The rates of perforation and deep mural injury were obtained. The factors associated with an unfavorable evolution after the placement of the endoclips were analyzed. Results after 342 endoscopic mucosal resections (EMR) and 42 endoscopic submucosal dissections (ESD), there were 25 cases with perforation or deep mural injury. The deep mural injury rate was 3.22 % and 7.14 % in the case of EMR and ESD, respectively. The perforation rate was 1.46 % and 14.29 % in the case of EMR and ESD, respectively. Successful closure with endoclips was achieved in 24 cases (96 %). Only one patient presented an unfavorable evolution (10 %) after successful closure. The factors associated with an unfavorable evolution were the presence of diffuse peritoneal symptoms and a perforation size greater than or equal to 10 mm. Conclusion endoscopic closure with endoclips is effective to avoid surgery in cases of deep mural injury or perforation after an endoscopic resection.
Databáze: OpenAIRE