Published online Sep 7, 2016. doi: 10.3748/wjg.v22.i33.7453
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
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.
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.