RESUMO
BACKGROUND: new alternatives for entry site closure (ESC) in per-oral endoscopy myotomy (POEM) and gastric peroral endoscopy myotomy (G-POEM) have appeared. OBJECTIVE: to compare the over-the-scope-clip (OTSC®) and conventional clips (CC) for ESC in POEM and G-POEM. MATERIAL AND METHODS: a retrospective review of a prospective POEM and G-POEM database was performed between January 2015 and August 2019. A description was made of outcomes, using either OTSC® or CC for submucosal tunnel closure. RESULTS: forty-six POEM and 26 G-POEM were included in the study (23/13 per group [CC/OTSC®]). There were no clinical or procedure differences. ESC was performed with 1 OTSC® vs 5 CC and 1 vs 6 (p = 0.01) for POEM and G-POEM, respectively. Adverse events associated with clips were 21.7% vs 13% (p = 0.01) and 7.7% vs 0% (p = 0.02) for CC and OTSC® in POEM and G-POEM, respectively. CONCLUSION: OTSC® represents a safe and effective alternative for entry site closure in POEM and G-POEM cases. Further studies are needed to recommend OTSC® as the first option for submucosal tunnel closure in these procedures
No disponible
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Esofagoscopia/métodos , Piloromiotomia/métodos , Acalasia Esofágica/cirurgia , Instrumentos Cirúrgicos , Estudos Retrospectivos , Estudos ProspectivosRESUMO
BACKGROUND: new alternatives for entry site closure (ESC) in per-oral endoscopy myotomy (POEM) and gastric peroral endoscopy myotomy (G-POEM) have appeared. OBJECTIVE: to compare the over-the-scope-clip (OTSC®) and conventional clips (CC) for ESC in POEM and G-POEM. MATERIAL AND METHODS: a retrospective review of a prospective POEM and G-POEM database was performed between January 2015 and August 2019. A description was made of outcomes, using either OTSC® or CC for submucosal tunnel closure. RESULTS: forty-six POEM and 26 G-POEM were included in the study (23/13 per group [CC/OTSC®]). There were no clinical or procedure differences. ESC was performed with 1 OTSC® vs 5 CC and 1 vs 6 (p = 0.01) for POEM and G-POEM, respectively. Adverse events associated with clips were 21.7% vs 13% (p = 0.01) and 7.7% vs 0% (p = 0.02) for CC and OTSC® in POEM and G-POEM, respectively. CONCLUSION: OTSC® represents a safe and effective alternative for entry site closure in POEM and G-POEM cases. Further studies are needed to recommend OTSC® as the first option for submucosal tunnel closure in these procedures.
Assuntos
Acalasia Esofágica , Cirurgia Endoscópica por Orifício Natural , Piloromiotomia , Acalasia Esofágica/cirurgia , Esfíncter Esofágico Inferior , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Instrumentos Cirúrgicos , Resultado do TratamentoRESUMO
ANTECEDENTES: se desconoce la prevalencia de pólipos en intestino delgado (ID) en pacientes acromegálicos. OBJETIVO: evaluar la prevalencia de pólipos/tumores en ID en pacientes acromegálicos. Material: estudio prospectivo observacional que compara la prevalencia de pólipos/tumores utilizando cápsula endoscópica con un protocolo estandarizado en pacientes asintomáticos con acromegalia y pacientes no acromegálicos con dolor abdominal, diarrea o anemia. RESULTADOS: se incluyeron 183 casos (61 acromegálicos y 122 no acromegálicos). Se encontraron seis (9,8%) y tres (2,5%) pólipos respectivamente (RR: 4 [IC 95%, 1,03-15,45; p = 0,038]). Sin diferencias en tumores (n = 4, 6,6% vs. n = 7, 5,7%). CONCLUSIONES: la acromegalia puede asociar más pólipos en ID
No disponible
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Polipose Intestinal/diagnóstico por imagem , Polipose Intestinal/complicações , Cápsulas Endoscópicas , Endoscopia por Cápsula , Acromegalia/complicações , Estudos ProspectivosRESUMO
BACKGROUND: the prevalence of small bowel (SB) polyps is unknown in acromegaly patients. OBJECTIVE: to evaluate the prevalence of polyps/tumors in SB of acromegaly patients. MATERIAL: this was a prospective and observational study that compared the prevalence of polyps/tumors using capsule endoscopy with a standard protocol in asymptomatic acromegaly patients and non-acromegaly patients, with abdominal pain, diarrhea or anemia. RESULTS: one hundred and eighty-three cases were included (61 acromegaly and 122 non-acromegaly). Polyps were found in six (9.8%) and three (2.5%) patients, respectively (RR: 4 [95% CI, 1.03-15.45; p = 0.038]). There were no differences in the tumors (n = 4, 6.6% vs n = 7, 5.7%). CONCLUSIONS: acromegaly may be associated with more polyps in SB.
