TY - JOUR
T1 - Gastrointestinal defect closure using a novel through-the-scope helix tack and suture device compared to endoscopic clips in a survival porcine model (with video)
AU - Hernandez, Ariosto
AU - Marya, Neil B.
AU - Sawas, Tarek
AU - Rajan, Elizabeth
AU - Gades, Naomi M.
AU - Wong Kee Song, Louis M.
AU - Abu Dayyeh, Barham K.
AU - Buttar, Navtej
AU - Storm, Andrew C.
N1 - Publisher Copyright:
© 2021 Thieme Medical Publishers, Inc.. All rights reserved.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Background and aims Endoscopic resections are associated with bleeding and perforation and may be managed with through-the-scope (TTS) clips, over-the-scope clips and endoscopic suturing. The aim of this preclinical study was to compare technical success of closure using a novel TTS tissue helix tack and suture device (X-Tack) to TTS clips in a porcine model. Materials and methods Four subjects underwent 40 mucosal resections, diameter range 25-50mm, in the stomach (n=24) and colon (n=16). Closures were randomized to X-Tack (n=24) or clip (n=16). Animals underwent weekly endoscopic follow-up for 4 weeks. Results Technical closure with X-Tack was successful in 24 of 24 (100%) cases and with clips in 13 of 16 cases (81.3%) (P =0.0001). One colonic perforation occurred and was successfully managed using X-Tack. The rate of healing was not statistically different between the groups, and all sites healed at 4 weeks including the perforation and were confirmed by histology. Conclusions Compared to TTS clip, X-Tack is superior for effecting large mucosal defect closure, including durable sealing of full-thickness perforation. There was no difference in rate of healing between devices.
AB - Background and aims Endoscopic resections are associated with bleeding and perforation and may be managed with through-the-scope (TTS) clips, over-the-scope clips and endoscopic suturing. The aim of this preclinical study was to compare technical success of closure using a novel TTS tissue helix tack and suture device (X-Tack) to TTS clips in a porcine model. Materials and methods Four subjects underwent 40 mucosal resections, diameter range 25-50mm, in the stomach (n=24) and colon (n=16). Closures were randomized to X-Tack (n=24) or clip (n=16). Animals underwent weekly endoscopic follow-up for 4 weeks. Results Technical closure with X-Tack was successful in 24 of 24 (100%) cases and with clips in 13 of 16 cases (81.3%) (P =0.0001). One colonic perforation occurred and was successfully managed using X-Tack. The rate of healing was not statistically different between the groups, and all sites healed at 4 weeks including the perforation and were confirmed by histology. Conclusions Compared to TTS clip, X-Tack is superior for effecting large mucosal defect closure, including durable sealing of full-thickness perforation. There was no difference in rate of healing between devices.
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U2 - 10.1055/a-1370-9256
DO - 10.1055/a-1370-9256
M3 - Article
C2 - 33860074
AN - SCOPUS:85104059106
SN - 2196-9736
VL - 9
SP - E572-E577
JO - Endoscopy International Open
JF - Endoscopy International Open
IS - 4
ER -