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Role of over the scope clips in the management of iatrogenic gastrointestinal perforations

World Journal of Gastroenterology 2014年第32期20卷 11460-11462页

作者： Kinesh Changela Muhhamad A Virk Niravkumar Patel sushil duddempudi Mahesh Krishnaiah Sury Anand Division of Gastroenterology The Brooklyn Hospital Center New York Presbyterian Healthcare System Brooklyn NY 11201 United States

Advances in endoscopic and surgical techniques have increased the frequency and complexity of these procedures and associated complications such as gastrointestinal perforation. With the advancements in the field of gastroenterology, the promising use of an over the scope clips(OTSC) has fulfilled the unmet need for a reliable endoscopic devise in approximation of gastrointestinal perforation. This novel approach has raised the level of confidence in endoscopist in dealing with this serious complication during endoscopy. Here we have shared our experience with OTSC to evaluate its efficacy and safety in managing iatrogenic gastrointestinal perforations during endoscopy.

关键词： Gastrointestinal perforation Over-the-scope clip Over the scope clip system Endoscopic adverse events

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Peroral endoscopic reduction of dilated gastrojejunal anastomosis after bariatric surgery: Techniques and efficacy

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World Journal of Gastrointestinal Endoscopy 2016年第4期8卷 239-243页

作者： Kinesh Changela Emmanuel Ofori sushil duddempudi Sury Anand Shashideep Singhal Division of Gastroenterology the Brooklyn Hospital Center-Clinical Affiliate of Mount Sinai Hospital Division of Gastroenterology Hepatology and Nutrition University of Texas Health Science Center at Houston

AIM: To investigate the techniques and efficacy of peroral endoscopic reduction of dilated gastrojejunal anastomosis after bariatric ***: An extensive English language literature search was conducted using Pub Med, MEDLINE, Medscape and Google to identify peer-reviewed original and review articles using the keywords "bariatric endoscopic suturing", "overstitch bariatric surgery", "endoscopic anastomotic reduction", "bariatric surgery", "gastric bypass", "obesity", "weight loss". We identified articles describing technical feasibility, safety, efficacy, and adverse outcomes of overstitch endoscopic suturing system for transoral outlet reduction in patients with weight regain following Roux-en-Y gastric bypass(RYGB). All studies that contained material applicable to the topic were considered. Retrieved peer-reviewed original and review articles were reviewed by the authors and the data extracted using a standardized collection tool. Data were analyzed using statistical analysis as percentages of the event. RESULTS: Four original published articles which met our search criteria were pooled. The total number cases were fifty-nine with a mean age of 46.75 years(34-63 years). Eight of the patients included in those studies were males(13.6%) and fifty-one were females(86.4%). The mean time elapsed since the primary bypass surgery was 5.75 years. The average pre-endoscopic procedure body mass index(BMI) was 38.68(27.5-48.5). Mean body weight regained post-RYGB surgery was 13.4 kg from their post-RYGB nadir. The average pouch length at the initial upper endoscopy was 5.75 cm(2-14 cm). The pre-intervention anastomotic diameter was averaged at 24.85 mm(8-40 mm). Average procedure time was 74 min(50-164 min). Mean post endoscopic intervention anastomotic diameter was 8 mm(3-15 mm). Weight reduction at 3 to 4 mo post revision noted to be anaverage of 10.1 kg. Average overall post revision BMI was recorded at 37.7. The combined technical and clinical success rate was

关键词： Endoscopic anastomosis reduction Bariatricsurgery Endoscopic suturing EndoCinch Overstitchbariatric surgery

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