Subscribe to RSS
DOI: 10.1055/s-0043-108547
A novel endoloop system for closure of colonic mucosal defects through a single-channel colonoscope
Publication History
submitted 02 October 2016
accepted after revision 16 March 2017
Publication Date:
24 May 2017 (online)
Abstract
Background and study aims Successful closure of the postoperative mucosal defect is crucial for endoscopic treatment. The purse-string suture strategy via a double-channel endoscope has been recommended as being both safe and feasible for large gastrointestinal mucosal defects. However, for colonic treatment, use of a single-channel colonoscope is more popular because of its longer length and greater flexibility. A novel pre-detached endoloop system was therefore developed for endoscopic purse-string suture closure via a single-channel endoscope. This study evaluated its feasibility and efficacy, especially for right colonic mucosal defects.
Patients and methods A total of 18 patients with colonic defects post-endoscopic submucosal dissection (ESD) were treated using the single-channel endoscope method.
Results All mucosal defects were successfully closed using the novel closure technique. No severe complications, such as massive intraoperative bleeding, delayed bleeding, peritonitis, or perforation, were recorded. All patients recovered well after ESD and left the hospital within 7 days.
Conclusions This novel pre-detached endoloop strategy via a single-channel endoscope was safe and feasible for the closure of colonic mucosal defects using an endoscopic purse-string suture.
* Jiankun Wang and Lili Zhao contributed equally to this article.
-
References
- 1 Ryska O, Martinek J, Filipkova T. et al. Single loop-and-clips technique (KING closure) for gastrotomy closure after transgastric ovariectomy: a survival experiment. Wideochir Inne Tech Maloinwazyjne 2012; 7: 233-239
- 2 Tanaka S, Kashida H, Saito Y. et al. JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc 2015; 27: 417-434
- 3 Zhou PH, Yao LQ, Qin XY. Endoscopic submucosal dissection for colorectal epithelial neoplasm. Surg Endosc 2009; 23: 1546-1551
- 4 Zhang QS, Han B, Xu JH. et al. Clip closure of defect after endoscopic resection in patients with larger colorectal tumors decreased the adverse events. Gastrointest Endosc 2015; 82: 904-909
- 5 von Renteln D, Vassiliou MC, Rothstein RI. Randomized controlled trial comparing endoscopic clips and over-the-scope clips for closure of natural orifice transluminal endoscopic surgery gastrotomies. Endoscopy 2009; 41: 1056-1061
- 6 Yoshikane H, Hidano H, Sakakibara A. et al. Feasibility study on endoscopic suture with the combination of a distal attachment and a rotatable clip for complications of endoscopic resection in the large intestine. Endoscopy 2000; 32: 477-480
- 7 Matsuda T, Fujii T, Emura F. et al. Complete closure of a large defect after EMR of a lateral spreading colorectal tumor when using a two-channel colonoscope. Gastrointest Endosc 2004; 60: 836-838
- 8 Zhang Y, Wang X, Xiong G. et al. Complete defect closure of gastric submucosal tumors with purse-string sutures. Surg Endosc 2014; 28: 1844-1851
- 9 Zeng CY, Li GH, Zhu Y. et al. Single-channel endoscopic closure of large endoscopy-related perforations. Endoscopy 2015; 47: 735-738
- 10 Lua GW, Liu F. Closure of a large mucosal defect after endoscopic submucosal dissection using "pre-detached loop and clips" method with a single-channel gastroscope. Endoscopy 2015; 47 (Suppl. 01) E464-E465
- 11 Isomoto H, Nishiyama H, Yamaguchi N. et al. Clinicopathological factors associated with clinical outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms. Endoscopy 2009; 41: 679-683
- 12 Terasaki M, Tanaka S, Shigita K. et al. Risk factors for delayed bleeding after endoscopic submucosal dissection for colorectal neoplasms. Int J Colorectal Dis 2014; 29: 877-882
- 13 Shi D, Li R, Chen W. et al. Application of novel endoloops to close the defects resulted from endoscopic full-thickness resection with single-channel gastroscope: a multicenter study. Surg Endosc 2017; 31: 837-842