Endoscopic “rescue” treatment for gastrointestinal perforations, anastomotic dehiscence and fistula

Dabizzi, Emanuele; Ceglie, Antonella De; Baig, Kondal R. Kyanam Kabir; Baron, Todd H.; Conio, Mássimo; Wallace, Michael B.

doi:10.1016/j.clinre.2015.04.006

Cited by 7 publications

(8 citation statements)

References 131 publications

(188 reference statements)

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“…The risk of stent migration is high in the lower gastrointestinal tract because of the increased intestinal motility, and has been reported in 25% to 40% of patients[ 14 - 16 ]. This rate is lower in uncovered or partially covered stents than in biodegradable and fully covered stents[ 9 , 10 , 12 ].…”

Section: Endoscopic Sems and Other Stentsmentioning

confidence: 99%

“…This rate is lower in uncovered or partially covered stents than in biodegradable and fully covered stents[ 9 , 10 , 12 ]. Migration has been also described when large-diameter stents have been used[ 11 , 14 ]. However, the use of a partially covered SEMS prevents migration and allows for tissue in-growth; however, its removal is technically difficult[ 11 , 12 ].…”

Section: Endoscopic Sems and Other Stentsmentioning

confidence: 99%

“…However, the use of a partially covered SEMS prevents migration and allows for tissue in-growth; however, its removal is technically difficult[ 11 , 12 ]. Clips or endoscopic suturing are alternative methods to anchor the stent in place and to reduce migration risk[ 14 ] (Figure 1B ). Optimal timing of stent removal is controversial.…”

Section: Endoscopic Sems and Other Stentsmentioning

confidence: 99%

“…Recent advances and innovations in stent technology have led to the development expandable polydioxanone biodegradable stents as an effective alternative treatment of AL following colorectal surgery. The biodegradable stent does not to be removed, which can decrease mucosal hyperplastic reactions and adverse events associated with stent removal, compared with metal stents[ 9 , 10 , 12 , 14 ].…”

Section: Endoscopic Sems and Other Stentsmentioning

confidence: 99%

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Minimally invasive management of anastomotic leaks in colorectal surgery

Sevim

Çelik

Yavarifar

et al. 2016

WJGS

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Anastomotic leakage is an unfortunate complication of colorectal surgery. This distressing situation can cause severe morbidity and significantly affects the patient’s quality of life. Additional interventions may cause further morbidity and mortality. Parenteral nutrition and temporary diverting ostomy are the standard treatments of anastomotic leaks. However, technological developments in minimally invasive treatment modalities for anastomotic dehiscence have caused them to be used widely. These modalities include laparoscopic repair, endoscopic self-expandable metallic stents, endoscopic clips, over the scope clips, endoanal repair and endoanal sponges. The review aimed to provide an overview of the current knowledge on the minimally invasive management of anastomotic leaks.

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Section: Endoscopic Sems and Other Stentsmentioning

confidence: 99%

Section: Endoscopic Sems and Other Stentsmentioning

confidence: 99%

Section: Endoscopic Sems and Other Stentsmentioning

confidence: 99%

Section: Endoscopic Sems and Other Stentsmentioning

confidence: 99%

See 2 more Smart Citations

Minimally invasive management of anastomotic leaks in colorectal surgery

Sevim

Çelik

Yavarifar

et al. 2016

WJGS

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“…Although surgical management of gastric perforation is generally effective in traumatic stomach perforation, in situations wherein surgery is unfeasible or in a stable patients without sepsis, endoscopic treatment modalities can be considered as alternatives. Endoscopic treatment method with an endoloop and clips (purse-string suture technique) has showed good results in few reports for large iatrogenic gastrointestinal (GI) perforation closures caused after endoscopic therapeutic procedures [2][3][4] . Also a case report exhibited successful closure of small gastric penetrating stab wound with clips.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Repair of Delayed Stomach Perforation Arising From Penetrating Trauma: A Case Report

Yoon

Jun

Han

et al. 2020

Preprint

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Background Primary endoscopic closure of perforated gastric wall during endoscopic procedures is mostly effective and well-tolerated; however, there are only few studies on the efficacy of endoscopic management in traumatic delayed gastric perforation. Case presentation: Here, we report the case of a 39-year-old woman who presented with multiple penetrating trauma in the back and left abdominal cavity. Initial imaging studies revealed left diaphragmatic disruption and peri-splenic hemorrhage without gastric perforation. An emergency primary repair of the disrupted diaphragm with omental reduction and suture of the lacerated lung was performed; however, delayed free-perforation of the gastric wall was noted on computed tomography after 3 d. Following an emergency abdominal surgery for primary repair of the gastric wall, re-perforation was noted 15 d post-operatively. The high re-operation risk prompted an endoscopic intervention using two endoloops and 11 endoscopic clips using a novel modified purse-string suture technique. The free perforated gastric wall was successfully repaired without additional surgery or intervention. The patient was discharged after 46 d without any complications. Conclusions Endoscopic closure with this novel technique involving endoloops and endoscopic clips can be a useful therapeutic alternative to re-operation for delayed gastric perforation caused by penetrating trauma.

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Endoscopic repair of delayed stomach perforation caused by penetrating trauma: A case report

Yoon

Jun

Han

et al. 2021

WJCC

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BACKGROUND Primary endoscopic closure of a perforated gastric wall during endoscopic procedures is mostly effective and well-tolerated; however, there are very few studies on the efficacy of endoscopic management of delayed traumatic gastric perforation. Herein, we report a novel case of a patient who was successfully treated for delayed traumatic stomach perforation using an alternative endoscopic modality. CASE SUMMARY A 39-year-old woman presented with multiple penetrating traumas in the back and left abdominal cavity. Initial imaging studies revealed left diaphragmatic disruption and peri-splenic hemorrhage without gastric perforation. An emergency primary repair of the disrupted diaphragm with omental reduction and suturing of the lacerated lung was performed; however, delayed free perforation of the gastric wall was noted on computed tomography after 3 d. Following an emergency abdominal surgery for the primary repair of the gastric wall, re-perforation was noted 15 d postoperatively. The high risk associated with re-surgery prompted an endoscopic intervention using 2 endoloops and 11 endoscopic clips using a novel modified purse-string suture technique. The free perforated gastric wall was successfully repaired without additional surgery or intervention. The patient was discharged after 46 d without any complications. CONCLUSION Endoscopic closure with endoloops and clips can be a useful therapeutic alternative to re-surgery for delayed traumatic gastric perforation.

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Endoscopic “rescue” treatment for gastrointestinal perforations, anastomotic dehiscence and fistula

Cited by 7 publications

References 131 publications

Minimally invasive management of anastomotic leaks in colorectal surgery

Minimally invasive management of anastomotic leaks in colorectal surgery

Endoscopic Repair of Delayed Stomach Perforation Arising From Penetrating Trauma: A Case Report

Endoscopic repair of delayed stomach perforation caused by penetrating trauma: A case report

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