| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3307732 | Gastrointestinal Endoscopy | 2007 | 6 Pages |
BackgroundIt is unclear whether large gaping perforations of the colon can be closed by the endoluminal route.ObjectiveTo evaluate the feasibility and the outcome of closure of large perforations of colon with clips and sutures by using through-the-endoscope novel devices.DesignProspective animal study.SettingUniversity hospital.PatientsTen pigs.InterventionsClosure of a 4-cm full-thickness colon perforation freshly created by an insulated-tip knife with the InScope Multi-Clip Applier (n = 6) and with the tissue approximation device (n = 4).Main Outcome Measurements(a) Technical feasibility of closure, (b) clinical monitoring for 2 weeks, (c) necropsy (day 14), (d) healing by a dye-leak test and histology.ResultsEndoluminal closure of a 4-cm–long colon perforation was successful in 9 of 10 animals. The clips failed to close a gaping wide colon perforation in 1 animal. The sutures were successful in the closure of both nongaping and gaping perforations. Successful closure resulted in a leakproof sealing at 2 weeks and prevented clinical peritonitis in all the animals in the clip-closure group and in 3 of 4 animals in the suture-closure group. Necropsy at 2 weeks revealed mild peritonitis in 2 of the 5 animals in the clip closure group and in 2 of the 4 animals in the suture-closure group; none developed fecal peritonitis.LimitationsNone.ConclusionsEndoluminal closure of a 4-cm colon perforation with clips was successful in the majority of cases. Sutures were useful in the closure of gaping colon perforations that could not be closed with clips.
