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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2016; 22(33): 7453-7462
Published online Sep 7, 2016. doi: 10.3748/wjg.v22.i33.7453
New devices and techniques for endoscopic closure of gastrointestinal perforations
Yue Li, Jian-Hua Wu, Yan Meng, Qiang Zhang, Wei Gong, Si-De Liu
Yue Li, Jian-Hua Wu, Yan Meng, Qiang Zhang, Wei Gong, Si-De Liu, Department of Gastroenterology, Guangdong Provincial Key Laboratory of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Author contributions: Li Y drafted the article and made critical revisions related to important intellectual content of the manuscript; Wu JH and Meng Y drafted the article and acquired the data; Zhang Q and Gong W acquired and analyzed the data; Liu SD designed the research.
Supported by Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme; Guangzhou Pilot Project of Clinical and Translational Research Center, early gastrointestinal cancers, No. 7415696196402; Guangdong Provincial Bio-engineering Research Center for Gastroenterology Diseases.
Conflict-of-interest statement: The authors have no conflict of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Si-De Liu, MD, Professor, Department of Gastroenterology, Guangdong Provincial Key Laboratory of Gastroenterology, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Guangzhou 510515, Guangdong Province, China. liuside2011@163.com
Telephone: +86-20-61641537 Fax: +86-20-87280770
Received: March 27, 2016
Peer-review started: March 28, 2016
First decision: May 12, 2016
Revised: May 30, 2016
Accepted: June 15, 2016
Article in press: June 15, 2016
Published online: September 7, 2016
Abstract

Gastrointestinal perforations, which need to be managed quickly, are associated with high morbidity and mortality. Treatments used to close these perforations range from surgery to endoscopic therapy. Nowadays, with the development of new devices and techniques, endoscopic therapy is becoming more popular. However, there are different indications and clinical efficacies between different methods, because of the diverse properties of endoscopic devices and techniques. Successful management also depends on other factors, such as the precise location of the perforation, its size and the length of time between the occurrence and diagnosis. In this study, we performed a comprehensive review of various devices and introduced the different techniques that are considered effective to treat gastrointestinal perforations. In addition, we focused on the different methods used to achieve successful closure, based on the literature and our clinical experiences.

Keywords: Gastrointestinal perforations, Devices, Techniques, Endoscopic closure, Treatment

Core tip: We introduce and discuss endoscopic devices and techniques used to treat gastrointestinal perforations, based on the literature and our clinical experiences. Endoscopists should avoid causing perforations, especially during therapeutic procedures. Sometimes, an intentional perforation is necessary for the complete removal of a tumor. However, the integrity of the mucosa should be considered, and the retained mucous membrane could contribute to the effective closure of the perforation after full-thickness resection. We also provide advice for choosing the appropriate method to close perforations effectively.