Snapper fishbone esophageal perforation closed with an over-the-scope-clip

Ferreira, Alexandre Oliveira; Lopes, Joanne; Velosa, José

doi:10.1136/bcr-2013-201614

Cited by 6 publications

(2 citation statements)

References 3 publications

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“…Postoperative decompensation was defined as the development of new/worsening ascites, jaundice, hepatic encephalopathy, variceal bleeding and hepatorenal syndrome within 30-days of surgery. Length of stay [15] was calculated from the date of surgery to the date of discharge. Overall survival/follow-up was calculated from the date of surgery to the date of last follow-up/death using the Kaplan-Meier method.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for decompensation and death following umbilical hernia repair in patients with end-stage liver disease

Malik

Varghese

Pandanaboyana

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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Introduction Symptomatic umbilical hernias are a common cause of morbidity and mortality in patients with cirrhosis and end-stage liver disease (ESLD). This study set out to characterise the factors predicting outcome following repair of symptomatic umbilical hernias in ESLD at a single institution. Methods A retrospective review was performed of all patients with ESLD who underwent repair of a symptomatic umbilical hernia between 1998 and 2020. Overall survival was predicted using the Kaplan–Meier method. Logistic regression was used to determine predictors of decompensation and 30-day, 90-day and 1-year mortality. Results One-hundred-and-eight patients with ESLD underwent umbilical hernia repair (emergency n = 78, 72.2%). Transjugular shunting was performed in 29 patients (26.9%). Decompensation occurred in 44 patients (40.7%) and was predicted by emergency surgery (OR, 13.29; P = 0.001). Length of stay was shorter in elective patients compared to emergency patients (3-days vs. 7-days; P = 0.003). Thirty-day, 90-day and 1-year survival was 95.2, 93.2 and 85.4%, respectively. Model for ESLD score >15 predicted 90-day mortality (OR, 18.48; P = 0.030) and hyponatraemia predicted 1-year mortality (OR, 5.31; P = 0.047). Transjugular shunting predicted survival at 1 year (OR, 0.15; P = 0.038). Conclusions Repair of symptomatic umbilical hernias in patients with ESLD can be undertaken with acceptable outcomes in a specialist centre, however, this remains a high-risk intervention. Patients undergoing emergency repair are more likely to decompensate postoperatively, develop wound-related problems and have a longer length of stay. Transjugular shunting may confer a benefit to survival, but further prospective trials are warranted.

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Section: Methodsmentioning

confidence: 99%

Risk factors for decompensation and death following umbilical hernia repair in patients with end-stage liver disease

Malik

Varghese

Pandanaboyana

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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“…[25] Later, many clinical trials reported that this device was successfully applied for the full thickness closure of perforation, leakage and fistula. [26,27] Haito-Chavez et al [28] reported successful technical and clinical closure of the defect in all 188 patients by OTSC. Esophageal fistula was present in 16 of these cases, leakage in five, and perforation in 10.…”

Section: Through-the-scope (Tts) Clipsmentioning

confidence: 99%

Minimally invasive management of esophageal perforation

Eroğlu

Aydın

Yılmaz

2018

Turk Gogus Kalp Dama

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Minimally invasive management of esophageal perforation Özofagus perforasyonunun minimal invaziv tedavisi ÖZ Özofagus perforasyonu yüksek morbidite ve mortalite ile karakterize acil bir durumdur. Hayatı tehdit eden bu durumun uygun tedavisi konusunda kesin bir fikir birliği bulunmamaktadır. Geleneksel olarak özofagus perforasyonunun tedavisi cerrahidir. Bununla birlikte, endoskopik tedavi cerrahiden daha az invaziv ve daha az morbid olarak günümüzde primer tedavi seçimidir. Endoskopik klip uygulaması, endoskopik stent yerleştirilmesi, endoskopik sütür, endoskopik vakum tedavisi ve doku yapıştırıcıları endolüminal yoldan uygulanmaktadır. Küçük defektler (<2 cm) endoskopik klipler ile kapatılabilir. Daha büyük defektler stent yerleştirilmesi veya sütür gerektirir. Çıkartılabilir özofagus stenti, perforasyonun minimal invaziv onarımına ve hızlı beslenmeye izin vermesiyle özofagus perforasyonu olan olgularda etkili bir tedavi yöntemidir. Endoskopik sütür hem migrasyonu önlemek için stentin sabitlenmesi hem de perforasyonun primer olarak kapatılması için kullanılabilir. Perforasyon bir mediastinal koleksiyon ile ilişkili ise, drenaj zorunludur ve bu işlem bilgisayarlı tomografi rehberliğinde perkütan drenaj, torakoskopi veya endoskopik vakum tedavisi ile yapılabilir. Bazı olgularda bu minimal invaziv yöntemlerin kombinasyonu gerekir. Endoskopi merkezli minimal invaziv yöntemlerin daha iyi yaşam kalitesi ve sonuçlar sağlaması ve hastanede yatış süresini kısaltması nedeni ile özofagus perforasyonunda tedavi seçiminde bu yöntemlere doğru bir yönelim gözlenmektedir.

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Endoscopic Management of Esophageal Perforations: Who, When, and How?

Saxena

Khashab

2017

Curr Treat Options Gastro

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Esophageal perforations can be spontaneous or iatrogenic. Although they are a rare occurrence, they are associated with a significant morbidity and mortality. Traditionally, management of esophageal perforation consisted of surgery. However, endoscopic management is now emerging as the primary treatment modality and is less invasive and morbid than surgery. Endoscopic modalities include through-the-scope clips (TTS), over-the-scope clips (OTSC), placement of covered stents, and suturing. Suturing can be used for primary closure of the perforation as well as anchoring of stents to prevent migration. Smaller defects (<2 cm) can be closed with clips (TTS or OTSC), whereas larger defects require a stent placement or suturing to achieve closure. If the perforation is associated with a mediastinal collection, drainage is mandatory and can be done via CT-guided percutaneous drainage, surgery, or endoscopic vacuum therapy.

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Snapper fishbone esophageal perforation closed with an over-the-scope-clip

Cited by 6 publications

References 3 publications

Risk factors for decompensation and death following umbilical hernia repair in patients with end-stage liver disease

Risk factors for decompensation and death following umbilical hernia repair in patients with end-stage liver disease

Minimally invasive management of esophageal perforation

Endoscopic Management of Esophageal Perforations: Who, When, and How?

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