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World J Gastrointest Endosc. Oct 16, 2010; 2(10): 344-348
Published online Oct 16, 2010. doi: 10.4253/wjge.v2.i10.344
Evaluating long-term attachment of two different endoclips in the human gastrointestinal tract
Hendrik Albert Maurits Swellengrebel, Cornelia Adriana Maria Marijnen, Andrew Vincent, Annemieke Cats
Hendrik Albert Maurits Swellengrebel, Annemieke Cats, Department of Gastroenterology and Hepatology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam 1066CX, The Netherlands
Cornelia Adriana Maria Marijnen, Department of Radiation Oncology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam 1066 CX, The Netherlands
Cornelia Adriana Maria Marijnen, Department of Clinical Oncology, Leiden University Medical Centre, Post box 9600, Leiden 2300 RC, The Netherlands
Andrew Vincent, Department of Biostatistics, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam 1066CX, The Netherlands
Author contributions: Swellengrebel HAM, Marijnen CAM and Cats A were involved in the study design, acquisition of data, analysis and interpretation of data, drafting and revising the manuscript and the final approval; and Vincent A was involved in study design, statistical data analysis, interpretation of data and final approval of the manuscript.
Correspondence to: Hendrik Albert Maurits Swellengrebel, MD, Department of Gastroenterology and Hepatology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam 1066CX, The Netherlands. m.swellengrebel@nki.nl
Telephone: + 31-20-5122566 Fax: +31-20-5122572
Received: June 1, 2010
Revised: August 31, 2010
Accepted: September 7, 2010
Published online: October 16, 2010
Abstract

AIM: To evaluate the long-term attachment of two types of endoclips in the human gastrointestinal tract.

METHODS: In this prospective observational study, endoclips were placed and followed-up during endoscopies or using fluoroscopic images as part of a prospective feasibility study evaluating external beam radiotherapy (EBRT, wk 1-3) followed by high dose rate brachytherapy (HDRBT with an endoluminal applicator once a week for 3 wk, wk 9-11) in medically inoperablerectal cancer patients. Initially, the type and number of endoclips were chosenrandomly and later refined to 1 Resolution® clip (Microvasive) proximal and 2 Quickclips® (Olympus) distal to the tumor. Nine consecutive patients from between September 2007 and August 2008 were analyzed. Retention rates were evaluated over three different observational periods [period 1: pre-HDRBT (wk -2-8), period 2: during HDRBT (wk 9-11) and period 3: post-HDRBT (wk 12-16)].

RESULTS: In this study, a total of 44 clips were placed during endoscopy, either at the beginning or at the end of period 1. The Resolution clip had a higher overall retention rate than the Quickclip (P = 0.01). After a median period of 81 d after placement (in period 1), long-term retention rates for the Resolution clip and Quickclip clip were 67% and 35% respectively.

CONCLUSION: The Resolution clip has a high retention rate and is useful in situations where long-term attachment to the human gastrointestinal mucosa is warranted.

Keywords: Endoclip; Radiotherapy; Retention rate; Cancer; Delineation