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首页> 外文期刊>Gastrointestinal Endoscopy >Endoscopic suturing closure of large mucosal defects after endoscopic submucosal dissection: Is the technique, at all times, feasible and effective?
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Endoscopic suturing closure of large mucosal defects after endoscopic submucosal dissection: Is the technique, at all times, feasible and effective?

机译：内镜下黏膜下剥离后缝合大粘膜缺损的技术是否始终可行且有效？

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We read the article by Kantsevoy et al1 regarding endoscopic suturing closure of large mucosal defects after endoscopic submucosal dissection (ESD) by using an endoscopic suturing device. Twelve mucosal defects of the colon and stomach were closed by using the Overstitch device, with excellent results in terms of cost and adverse events.Defect closure after ESD via endoscopic suturing is an innovative procedure. We have found that defect closure via suturing after ESD, by using our suturing device, is effective.2 We agree that this technique can eliminate the need for hospitalization and reduce the number and severity of adverse events. However, in our experience, closure of mucosal defects by using endoscopic suturing has some limitations. Additional ESD or ablation is difficult to perform in cases of residual cancer after ESD; therefore, additional resection or ablative treatments might be required after ESD, before defect closure.3'4 Additionally, closure of the mucosal defect around the cardia or pylorus could induce stenosis because of stomach deformity. The risk of stenosis after lesion resection must be considered in cases of lesion location near the anal canal or ileocecal valve in the colon, for example.
机译：我们阅读了Kantsevoy等人的文章，内容是关于使用内窥镜缝合装置进行内窥镜黏膜下剥离术（ESD）后大黏膜缺损的内窥镜缝合闭合。使用Overstitch装置可闭合十二个结肠和胃的粘膜缺损，在成本和不良事件方面均具有优异的效果。ESD内窥镜缝合后的缺损闭合是一种创新的方法。我们发现，通过使用我们的缝合设备进行ESD缝合，可以闭合缺损。2我们同意，该技术可以消除住院的需要，并减少不良事件的数量和严重性。然而，根据我们的经验，通过内窥镜缝合闭合粘膜缺损有一定的局限性。如果在ESD后残留癌症，则很难进行额外的ESD或消融;因此，在ESD闭合后，可能需要进行额外的切除或消融治疗，然后再闭合缺损。3'4此外，由于胃畸形，闭合the门或幽门周围的粘膜缺损可能引起狭窄。例如，如果病变的位置靠近结肠的肛门管或回盲瓣，则必须考虑病变切除后狭窄的风险。

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