Comparative analysis the effects of hemoclips and endoloop-clips technique for closure of large sigmoid colon perforations in experimental simulation model. A REIS multicenter study

Aims Large colon perforation is difficult to closure endoscopically, especially in the sigmoid colon, which is more difficult due to excessive mobility. Therefore, the aim of study was to evaluate the efficacy of the hemoclips and endoloop-clip technique for closure of large sigmoid colon perforations.

Methods This study was designed as a prospective, randomized controlled, and ex-vivo study. A total of 40 full-thickness, standardized defects measuring 3 cm were create in fresh ex vivo porcine sigmoid colon specimens. Two experienced endoscopists each completed 10 cases with conventional hemoclip technique (hemoclip group) and 10 cases with the endoloop-clips technique (endoloop-clip group). An independent observer measured the procedure time and performed an air insufflation test and a water leak test.

Results The mean total procedure time (10.8 2.5 vs 14.5 7.3 min, P=0.044) and number of ineffective hemoclip placement per case (0.05 0.22 vs 0.70 0.98, P=0.009) were significantly lower in the endoloop-clip group than the hemoclip group. the mean number of hemoclips used per case (9.1 2.4, 7.9 1.7, P=0.083), technical success rate, positive air insufflation test and complete closure rate by water leak test (hemoclip; 50% vs endoloop-clip; 65%, P=0.337) were not significantly different between two group. Multivariate analyses showed that the total procedure time was the only factor significantly associated with incomplete closure. (OR, 1.16; 95% CI, 1.003-1.334; P=0.045)

Conclusions The endoloop-clip technique seems to reduce the procedure time and ineffective hemoclip placement than conventional hemoclip technique in large perforations of sigmoid colon.

 

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Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publikationsverlauf

Artikel online veröffentlicht:
14. April 2023