Surgical Endoscopy ( IF 2.4 ) Pub Date : 2024-01-29 , DOI: 10.1007/s00464-024-10671-8 Xiaomeng Jiang 1, 2 , Chunhua Ni 3 , Fatema Tabak 1 , Yi Li 1 , Faming Zhang 2, 4
Background
Iatrogenic colonoscopy perforation (ICP) is a rare but most serious complication during colonoscopy investigation. However, endoscopic closure plays an important role in the dealing with ICP with the development of endoscopic techniques presently, there are still some portion of patients transferred to surgery.
Methods
Once a perforation was detected, endoclips were used to closed the defect of the colon. Then a colonic TET was planted inside the colon. The terminal end of the TET was put proximally to or near the location of the perforation. Then gas and fluid was sucked out through the TET with a syringe every 4 h.
Results
Three cases were treated with endoclip closure and colonic TET drainage. Case 1 was caused by urgent immediate perforation during routine colonoscopy, case 2 was delayed perforation after snare resection, and case 3 was ESD-related perforation. All patients got healed, no one transferred to surgery.
Conclusions
A combination of endoclip closure and colonic TET drainage might be an easy and potential method in the dealing with different types of ICP. This study may offer a novel paradigm for addressing endoscopy-related intestinal perforations.
中文翻译:
Endoclip联合结肠经内镜肠管:治疗医源性结肠镜穿孔的新方法
背景
医源性结肠镜穿孔(ICP)是结肠镜检查过程中罕见但最严重的并发症。但随着目前内镜技术的发展,内镜缝合在ICP的治疗中发挥着重要作用,仍有部分患者转入手术治疗。
方法
一旦检测到穿孔,就使用内夹来闭合结肠的缺损。然后将结肠 TET 植入结肠内。 TET 的末端放置在穿孔位置的近端或附近。然后每 4 小时用注射器通过 TET 吸出气体和液体。
结果
3例采用内夹闭合和结肠TET引流术治疗。病例1为常规结肠镜检查时紧急即刻穿孔,病例2为圈套器切除术后延迟穿孔,病例3为ESD相关穿孔。所有患者均痊愈,无一人转入手术室。
结论
内夹闭合和结肠 TET 引流相结合可能是治疗不同类型 ICP 的一种简单且潜在的方法。这项研究可能为解决内窥镜相关肠穿孔问题提供一种新的范例。