The Control Study of Endoscopic Closure with Acute Perforation and Laparoscopic Repair

Abstract Objective: To make analysis on the curative effect on the technique of endoscopic closure and laparoscopic closure, and explore the effect and safety of acute perforation of the endoscopic closure technique. Methods: Analysis on the 40 therapeutic cases of laparoscopic repair and endoscopic closure treatments, respectively, to submucosal tumours (SMT) of the stomach removed through ESE/EFR. According to the double-sample t-test, the differences of operation time and medical expenses between the two closure methods were compared and analyzed. And used the chi-square test to compare the difference in terms of operational difficulty and effects. Results: Postoperative pathology of 76 therapeutic cases operated through ESE and EFR was diagnosed as mesenchymal tumor and 4 cases as leiomyoma, among which 34 cases were in fundus ventriculi, 30 in corpus ventriculi and 16 in antrum. Endoscopic closure is significantly lower than laparoscopic closure in operation time span (endoscopic closure VS laparoscopic repair 74.70±23.55min vs 178.35±38.98min, p < 0.001) , medical expenses (endoscopic closure VS laparoscopic repair 28463.55±8228.96rmb vs 61848.75±8812.12rmb, p < 0.001) and inpatient days (endoscopic closure VS laparoscopic repair 10.50±3.49days vs. 16.95±4.58days, P < 0.01), while there is no significant difference in terms of technical difficulty and effects (P > 0.05). Conclusion: With the training and technical progress of endoscopic closure, it is safe, effective and quick in recovery to have non-laparoscopic assisted surgery on gastric wall closure.

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Study of the Comparison of Endoscopic Closure and Laparoscopic Repair of Defect of Gastric Wall

10.21203/rs.3.rs-104761/v1 ◽

2020 ◽

Author(s):

Qiao Qiao ◽

Huiming Tu ◽

Bojian Fei ◽

Kebin Xu ◽

Fan Yang ◽

...

Keyword(s):

Laparoscopic Repair ◽

Gastric Wall ◽

Operation Time ◽

Technical Difficulty ◽

Chi Square ◽

Medical Expenses ◽

Endoscopic Closure ◽

Significant Difference ◽

Acute Perforation ◽

Laparoscopic Closure

Abstract Objective: To make analysis on the curative effect on the technique of endoscopic closure and laparoscopic closure, and explore the effect and safety of acute perforation of the endoscopic closure technique. Methods: Analysis on the 40 therapeutic cases of laparoscopic repair and endoscopic closure treatments, respectively, to submucosal tumours (SMT) of the stomach removed through ESE/EFR. According to the double-sample t-test, the differences of operation time and medical expenses between the two closure methods were compared and analyzed. And used the chi-square test to compare the difference in terms of operational difficulty and effects. Results: Postoperative pathology of 76 therapeutic cases operated through ESE and EFR was diagnosed as mesenchymal tumor and 4 cases as leiomyoma, among which 34 cases were in fundus ventriculi, 30 in corpus ventriculi and 16 in antrum. Endoscopic closure is significantly lower than laparoscopic closure in operation time span (endoscopic closure VS laparoscopic repair 74.70±23.55min vs 178.35±38.98min, p < 0.001) , medical expenses (endoscopic closure VS laparoscopic repair 28463.55±8228.96rmb vs 61848.75±8812.12rmb, p < 0.001) and inpatient days (endoscopic closure VS laparoscopic repair 10.50±3.49days vs. 16.95±4.58days, P < 0.01), while there is no significant difference in terms of technical difficulty and effects (P > 0.05). Conclusion: With the training and technical progress of endoscopic closure, it is safe, effective and quick in recovery to have non-laparoscopic assisted surgery on gastric wall closure.

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Emergency Left Colon Resection for Acute Perforation. Primary Anastomosis or Hartmann’s Procedure? A Case-matched Control Study

World Journal of Surgery ◽

10.1007/s00268-007-9199-8 ◽

2007 ◽

Vol 31 (11) ◽

pp. 2117-2124 ◽

Cited By ~ 43

Author(s):

Stefan Breitenstein ◽

Armin Kraus ◽

Dieter Hahnloser ◽

Marco Decurtins ◽

Pierre-Alain Clavien ◽

...

Keyword(s):

Matched Control ◽

Primary Anastomosis ◽

Colon Resection ◽

Left Colon ◽

Hartmann’S Procedure ◽

Hartmann's Procedure ◽

Acute Perforation ◽

Control Study

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Open vs laparoscopic repair of abdominal hernia: a case control study in over 60 years old patients

BMC Surgery ◽

10.1186/1471-2482-13-s1-a19 ◽

2013 ◽

Vol 13 (S1) ◽

Author(s):

Massimiliano Fabozzi ◽

Rosaldo Allieta ◽

Luciano Grimaldi ◽

Stefano Reggio ◽

Bruno Amato ◽

...

Keyword(s):

Laparoscopic Repair ◽

Case Control Study ◽

Case Control ◽

Abdominal Hernia ◽

Old Patients ◽

Control Study

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Emergency Laparoscopic Repair of an Iatrogenic Gastric Perforation in a Hiatal Hernia following a Failed Endoscopic Closure

Case Reports in Surgery ◽

10.1155/2020/5060962 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Benjamin L. Reed ◽

Lawrence E. Tabone ◽

Nova Szoka ◽

Salim Abunnaja

Keyword(s):

Hiatal Hernia ◽

Laparoscopic Repair ◽

Surgical Repair ◽

Gastric Perforation ◽

Endoscopic Retrograde ◽

Endoscopic Procedures ◽

Abdominal Drain ◽

Endoscopic Closure ◽

Life Threatening ◽

Life Threatening Complication

Iatrogenic gastrointestinal perforation is a rare, life-threatening complication of endoscopic procedures, which requires either endoscopic or surgical repair. We report the account of an 82-year-old woman with an iatrogenic gastric perforation of a hiatal hernia secondary to an endoscopic retrograde cholangiopancreatography (ERCP) procedure. Despite immediate recognition of the complication and endoscopic closure with through-the-scope (TTS) clips, the patient developed mediastinitis, peritonitis, and sepsis. She subsequently underwent an emergency laparoscopic hiatal hernia dissection and repair of the perforation with mediastinal and peritoneal washout. Given the patient’s age and the degree of insult, subdiaphragmatic anchoring with abdominal drain placement was performed, and the hiatus was left open for additional drainage. The use of a side-viewing duodenoscope with the presence of a large hiatal hernia contributed to the risk of gastric perforation. We conclude that performing endoscopic procedures in patients with a known hiatal hernia should be carefully undertaken. If a perforation in such patients occurs, laparoscopic repair of such complications is feasible as demonstrated in this case video.

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