Experimental endoscopic repair of gastric perforations with an omental patch and clips

Hashiba, Kiyoshi; Carvalho, Ademar M. de; Diniz, Gerson; Andrade, Nestor Barbosa de; Guedes, Cizelene do Carmo Faleiros Veloso; Filho, Luis Siqueira; Lima, Cirilo Antônio Paula; Coehlo, Humberto Eustáquio; Oliveira, Rodrigo Alves de

doi:10.1067/mge.2001.118444

Cited by 56 publications

(26 citation statements)

References 24 publications

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“…The incentive for introducing these new operations was to simplify the procedure and make it suitable for minimal invasive therapy [9]. A few procedures can be accomplished by endoscopy, but often it still is necessary to combine it with laparotomy or laparoscopy [3,6]. Lau et al [5] described a method for closing the perforation using spongostan fixed with fibrin glue.…”

Section: Discussionmentioning

confidence: 99%

The “stamp method”: a new treatment for perforated peptic ulcer?

Bertleff¹,

Liem

Bartels

et al. 2006

Surg Endosc

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Section: Discussionmentioning

confidence: 99%

The “stamp method”: a new treatment for perforated peptic ulcer?

Bertleff¹,

Liem

Bartels

et al. 2006

Surg Endosc

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“…This is very important. Grasping of the submucosal layer by clips may be particularly important in the wound healing process in gastric wounds [16]. Mustoe et al [17] demonstrated that the intact gastric mucosa contributed only 14% of the total breaking strength of the fresh gastric wound.…”

Section: Discussionmentioning

confidence: 99%

Is Intraluminal Clip Application an Appropriate Treatment for Iatrogenic Gastric Perforation?

Karahasanoğlu

Altınlı²,

Hamzaoğlu³

et al. 2003

Eur Surg Res

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Background: The standard treatment of iatrogenic perforation has been an urgent operation. Recently, endoscopic clip application was recommended particularly for iatrogenic perforations. This study was designed to investigate the usage of surgical clips for gastric perforations. Method: Forty male rats were allocated to four groups. Following a midline laparotomy, a 5-mm gastrotomy was made at the fundic part of the stomach and through this ostomy a pre-pyloric perforation was created in all groups. In group I, the perforation site was closed with polypropylene sutures. In group II, the perforation site was closed extraluminally by vascular surgical clips. In group III, the perforation site was closed intraluminally by the same number of clips. In group IV, control group, the perforation site was left open. The animals were sacrificed on the 4th postoperative day. The healing of the perforation site was evaluated by the bursting pressure and the hydroxyproline content of the suture line. Results: Measurements revealed no differences in bursting pressure and hydroxyproline levels between the intraluminal clip application group (group III) and the group in which the perforation site was left open (group IV) (p > 0.05). Higher bursting pressures and hydroxyproline levels were observed in groups I and II compared to control group (p < 0.05). Conclusions: These results suggest that gastric perforations are not strengthened by intraluminal clip application. Further detailed clinical studies are necessary in order to conclude that intraluminal clip application is an appropriate treatment for iatrogenic perforation.

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“…When the defect is slightly larger than the width of the open clip, the defect should be closed using clips after a reduction of the diameter by air suction. Larger lesions can be managed by an omental-patch method, i.e., the defect is closed by clipping the gastric wall together with the omentum that was intentionally sucked into the gastric cavity (24,25). Thirdly, a thorough postoperative management is required, such as maintaining a semi-reclined position postoperatively, using intravenous antibiotics and PPIs.…”

Section: Discussionmentioning

confidence: 99%

A comparison of submucosal tunneling endoscopic resection and endoscopic full-thickness resection for gastric fundus submucosal tumors

et al. 2017

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Results: A total of 43 patients were enrolled: 15 underwent STER and the remaining 28 cases underwent EFTR. There were no significant differences between the two groups with regard to gender, age, tumor size, en bloc resection rate, operation time, pathohistological results and cost (p > 0.05). However, patients who underwent EFTR had a longer suture time, required a larger number of clips for closure and a prolonged postoperative hospital stay (p < 0.05). No recurrence was noted in either the STER or the EFTR group during a mean follow-up of 12.1 and 22.8 months, respectively. Conclusions:The treatment efficacy of STER and EFTR for the treatment of gastric fundus SMTs was comparable. However, STER has some advantages over EFTR in terms of suture time, the number of clips required for closure and postoperative hospital stay.

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Experimental endoscopic repair of gastric perforations with an omental patch and clips

Cited by 56 publications

References 24 publications

The “stamp method”: a new treatment for perforated peptic ulcer?

The “stamp method”: a new treatment for perforated peptic ulcer?

Is Intraluminal Clip Application an Appropriate Treatment for Iatrogenic Gastric Perforation?

A comparison of submucosal tunneling endoscopic resection and endoscopic full-thickness resection for gastric fundus submucosal tumors

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