Management of perforations during endoscopic resection.
Ludovico Alfarone1, Marco Spadaccini2, Alessandro Repici2
1Humanitas Clinical and Research Center, IRCCS-, Endoscopy Unit, Rozzano, Italy.
Best Practice & Research. Clinical Gastroenterology
|May 15, 2024
Summary
Endoscopic perforation is a serious risk during therapeutic endoscopy. Prompt diagnosis and immediate endoscopic closure using various tools can prevent surgery and improve patient outcomes.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
Background:
- Perforation remains a significant complication of therapeutic endoscopy.
- Advanced endoscopic resection techniques increase the incidence of intraprocedural perforations.
Purpose of the Study:
- To review the management of perforations during endoscopic resections.
- To analyze the characteristics, benefits, drawbacks, and future of endoscopic closure tools.
Main Methods:
- Literature review of endoscopic closure techniques for iatrogenic perforations.
- Analysis of traditional and novel endoscopic closure modalities.
Main Results:
- Immediate endoscopic closure is the primary treatment for iatrogenic perforations.
- Available closure tools include clips, suturing devices, stents, and vacuum therapy.
- Literature on endoscopic closure of perforations is limited.
Conclusions:
- Endoscopic closure is a vital first-line option for managing endoscopic resections perforations.
- A comprehensive understanding of available closure tools is crucial for endoscopists.
- Further research is needed to expand the armamentarium for closing these defects.
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