Comparison of endoscopic band ligation and endoclip closure of colonic perforation: <scp>T</scp>echnical feasibility and efficacy in an <scp>ex vivo</scp> pig model

Lee, Tae Hoon; Han, Joung Ho; Jung, Yoonho; Lee, Suck-Ho; Kim, Daehoon; Shin, Jong-Il; Lee, Tae Soo; Kim, Myung–Hwan; Choi, Seok Hwa; Kim, Hyun; Park, Seon-Mee; Youn, Sei-jin

doi:10.1111/den.12266

Cited by 6 publications

(7 citation statements)

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“…In addition, there have been recent reports of successful endoscopic closure of iatrogenic bowel perforations by using EBL after the failure of endoclips [ 15 , 16 ]. Also, after our pilot studies on the colon in an ex vivo porcine model [ 17 ], we aimed to evaluate whether colon perforations could be closed effectively with EBL. We explored the feasibility of endoluminal closure of 15-mm perforations by using EBL.…”

Section: Discussionmentioning

confidence: 99%

“…Our group reported rescue EBL for gastric perforation resulting from endoscopic submucosal dissection (ESD) or ulcer, and for iatrogenic colon perforation during endoscopy [ 15 , 16 ]. We also have shown that the technical feasibility and efficacy of EBL in endoluminal closure were not inferior to those of TTS endoclips in an ex vivo porcine model [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Endoluminal Closure of Colon Perforation with Endoscopic Band Ligation: Technical Feasibility and Safety in an In Vivo Canine Model

et al. 2015

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Background/Aims:Endoscopic band ligation (EBL) is an accepted method in the management of variceal bleeding; however, there is little evidence on the safety and feasibility of EBL for the closure of bowel perforation. In this study, we aimed to evaluate the technical feasibility and efficacy of EBL in iatrogenic colon perforation by using a canine model.Methods:We established an iatrogenic colon perforation model by using seven beagle dogs. Longitudinal 1.5- to 1.7-cm colon perforations were created with a needle knife and an insulated-tip knife, and the perforation was subsequently closed with EBL. During a 2-week follow-up period, the animals were carefully monitored and then euthanized for pathologic examination.Results:The EBL of iatrogenic colon perforations was successful in all dogs. The mean procedure time for EBL closure with one to three bands was 191.7 seconds, and there were no immediate complications. One animal was euthanized after 3 days because of peritonitis. There were no clinical and laboratory features of sepsis or peritonitis in the remaining six animals. On necropsy, we did not find any fecal peritonitis, pericolonic abscess formation, or transmural dehiscence at the perforation site. Histopathology demonstrated inflamed granulation tissue and scar lesions replaced by fibrosis.Conclusions:EBL might be a feasible and safe method for the management of iatrogenic colon perforations in an in vivo model.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endoluminal Closure of Colon Perforation with Endoscopic Band Ligation: Technical Feasibility and Safety in an In Vivo Canine Model

et al. 2015

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“…Although intestinal perforation during routine colonoscopy occurs at times, such a large perforation and adjacent to the anus is rare . It carries enormous challenges for management and risk of severe infection and potential injury to the anus.…”

Section: Brief Explanationmentioning

confidence: 99%

Endoscopic purse‐string suture technique: An effective remedy for a large iatrogenic rectal perforation

Chen

Wan

2018

Digestive Endoscopy

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“…EBL is easy, safe, quick and effective. Lee et al[26] compared the EBL technique with endoclips for the closure of colonic perforations. Closure by EBL was faster than closure by endoclipping (3.2 ± 1.7 min vs 6.8 ± 1.3 min, P < 0.01).…”

Section: New Devices and Techniquesmentioning

confidence: 99%

“…EBL may prolong the hospital stay by binding together more tissue than required. In addition, it can cause injury to adjacent organs[25,26,54]. Further studies and developments are needed to expand EBL’s clinical use.…”

Section: New Devices and Techniquesmentioning

confidence: 99%

New devices and techniques for endoscopic closure of gastrointestinal perforations

Meng

et al. 2016

WJG

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Gastrointestinal perforations, which need to be managed quickly, are associated with high morbidity and mortality. Treatments used to close these perforations range from surgery to endoscopic therapy. Nowadays, with the development of new devices and techniques, endoscopic therapy is becoming more popular. However, there are different indications and clinical efficacies between different methods, because of the diverse properties of endoscopic devices and techniques. Successful management also depends on other factors, such as the precise location of the perforation, its size and the length of time between the occurrence and diagnosis. In this study, we performed a comprehensive review of various devices and introduced the different techniques that are considered effective to treat gastrointestinal perforations. In addition, we focused on the different methods used to achieve successful closure, based on the literature and our clinical experiences.

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Comparison of endoscopic band ligation and endoclip closure of colonic perforation: Technical feasibility and efficacy in an ex vivo pig model

Abstract: Endoluminal closure of a 1.5-cm colon perforation with EBL decreased procedure time and was not inferior in leak pressure compared with endoclipping in this ex vivo porcine model.

Cited by 6 publications

References 48 publications

Endoluminal Closure of Colon Perforation with Endoscopic Band Ligation: Technical Feasibility and Safety in an <i>In Vivo</i> Canine Model

Endoluminal Closure of Colon Perforation with Endoscopic Band Ligation: Technical Feasibility and Safety in an <i>In Vivo</i> Canine Model

Endoscopic purse‐string suture technique: An effective remedy for a large iatrogenic rectal perforation

New devices and techniques for endoscopic closure of gastrointestinal perforations

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