TY - JOUR
T1 - Endoluminal closure of large perforations of colon with clips in a porcine model (with video)
AU - Raju, Gottumukkala S.
AU - Ahmed, Ijaz
AU - Brining, Douglas
AU - Xiao, Shu Yuan
N1 - Funding Information:
No financial or other interests in the manufacture or distribution of any device or drug mentioned in this article. No patents, equity holdings, and consulting fees. The University of Texas Medical Branch has received financial support for endoscopic research from Pentax Medical Corp, and from Microvasive Endoscopy, Boston Scientific Corp for this project. G. S. Raju has received honoraria from Pentax Medical Corp and Microvasive Endoscopy, Boston Scientific Corp during the last year. The study was partially funded by Penatx Medical Corp, Microvasive Endoscopy, Boston Scientific Corp, and the University of Texas Medical Branch, Galveston, Texas.
Funding Information:
We greatly appreciate Jay Pasricha for guidance in endoscopic research. We are grateful to Pentax Medical Company, Montvale, New Jersey, for supporting the animal endoscopy laboratory with equipment and Microvasive Endoscopy, Boston Scientific Co, Natick, Massachusetts, for partially funding this study. We thank Ree Lowery and Jason Whitehead for supplying the Resolution clips and the Institutional Animal Care and Use Committee and Animal Resource Center staff for their cooperation and generous support in helping us pursue endoscopic research.
PY - 2006/10
Y1 - 2006/10
N2 - Background: Endoluminal clip closure of small perforations of the colon is possible. It is unclear whether large perforations of the colon can be closed with clips deployed through a colonoscope. Objectives: To evaluate the technical feasibility and outcome of endoluminal closure of large perforations of the colon with clips. Design: Pilot study. Subjects: Eight pigs. Interventions: Endoluminal clip closure of large perforations of the colon. Main Outcome Measurements: Technical feasibility of endoluminal closure was evaluated in 8 animals. A dye leak test was performed to evaluate quality of endoluminal sealing immediately after closure and 2 weeks after closure. The animals in the survival group were monitored daily for 2 weeks for sepsis and peritonitis. Necropsy was done on day 14 to check for fecal peritonitis, wound dehiscence, and histological healing of perforation. Results: Endoscopic closure of colon perforation was successful in 6 of 8 animals; in 2 animals closure was unsuccessful due to prolapse of adjacent viscera into the colon (n = 1) and severe bleeding that obscured the view (n = 1). There was a leak-proof sealing of the perforation site in 2 animals tested immediately and in all the animals tested (n = 3) 2 weeks after closure. All 4 animals in the survival group recovered well, without any sepsis or peritonitis. Necropsy did not reveal fecal peritonitis or pericolonic abscess formation. The perforation site demonstrated a thin scar and there was histological healing. Conclusions: Endoluminal application of clips is successful in the closure of a large perforation of the colon in a porcine model.
AB - Background: Endoluminal clip closure of small perforations of the colon is possible. It is unclear whether large perforations of the colon can be closed with clips deployed through a colonoscope. Objectives: To evaluate the technical feasibility and outcome of endoluminal closure of large perforations of the colon with clips. Design: Pilot study. Subjects: Eight pigs. Interventions: Endoluminal clip closure of large perforations of the colon. Main Outcome Measurements: Technical feasibility of endoluminal closure was evaluated in 8 animals. A dye leak test was performed to evaluate quality of endoluminal sealing immediately after closure and 2 weeks after closure. The animals in the survival group were monitored daily for 2 weeks for sepsis and peritonitis. Necropsy was done on day 14 to check for fecal peritonitis, wound dehiscence, and histological healing of perforation. Results: Endoscopic closure of colon perforation was successful in 6 of 8 animals; in 2 animals closure was unsuccessful due to prolapse of adjacent viscera into the colon (n = 1) and severe bleeding that obscured the view (n = 1). There was a leak-proof sealing of the perforation site in 2 animals tested immediately and in all the animals tested (n = 3) 2 weeks after closure. All 4 animals in the survival group recovered well, without any sepsis or peritonitis. Necropsy did not reveal fecal peritonitis or pericolonic abscess formation. The perforation site demonstrated a thin scar and there was histological healing. Conclusions: Endoluminal application of clips is successful in the closure of a large perforation of the colon in a porcine model.
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U2 - 10.1016/j.gie.2006.02.040
DO - 10.1016/j.gie.2006.02.040
M3 - Article
C2 - 16996362
AN - SCOPUS:33748709424
SN - 0016-5107
VL - 64
SP - 640
EP - 646
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 4
ER -