CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(08): E1070-E1074
DOI: 10.1055/a-0630-0566
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Feasibility of endoscopic mucosa-submucosa clip closure method (with video)

Toshihiro Nishizawa
1  Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
,
Shigeo Banno
2  Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
,
Satoshi Kinoshita
1  Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
,
Hideki Mori
2  Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
,
Yoshihiro Nakazato
3  Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
,
Yuichiro Hirai
2  Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
,
Yoko Kubosawa
2  Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
,
Yukie Sunata
2  Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
,
Misako Matsushita
2  Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
,
Toshio Uraoka
2  Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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Weitere Informationen

Publikationsverlauf

submitted 30. Januar 2018

accepted after revision 25. April 2018

Publikationsdatum:
10. August 2018 (online)

Abstract

Background and study aims We developed a new endoscopic closure technique using just conventional endoclips. The feasibility of endoscopic mucosa-submucosa clip closure method was evaluated in this clinical pilot study.

Patients and methods This study involved consecutive 25 patients who underwent colorectal endoscopic submucosal dissection. Endoclips were placed at the edge of the mucosal defect. Each arm of the endoclip gripped the mucosa and submucosa, respectively. The direction in which the endoclip grips were placed was parallel to the short axis of the defect. Several endoclips were applied in this way. As a result, the mucosal defect was significantly reduced in size. Additional clips were placed to achieve complete closure.

Results Mean size of resected specimen was 31.2 ± 11 mm. The success rate was 96 % (24/25). Mean procedure time was 9.6 ± 4.4 minutes. Mean number of endoclips was 9.3 ± 3.7. No complications were observed in any of the patients after the procedure.

Conclusion Endoscopic mucosa-submucosa clip closure method could close mucosal defect of size around 2 – 4 cm completely using just conventional endoclips, and it seems easy, simple and low cost.