Abstract
Objective To evaluate the feasibility and the safety of endoscopic closure for acute colon perforations with novel successive endoclips in animal model. Methods Approximately 1.5 to 2 cm colonic full-thickness resections were created with an electrotome in 3 Ba-Ma pigs that were under general anesthesia and were closed with the conventional endoclips and novel successive endoclips respectively. The procedure time and the efficacy of each endoclip were recorded. After the procedure, the general condition and physiological indicators were carefully monitored. After a follow-up of 1 week, the pigs were euthanized for an endoscopic observation of the healing condition and the residual endoclips. A postmortem examination was performed to observe the abdominal infection and incision condition. Transverse sections of the colon across the site of perforation were taken for histopathologic examination to assess the healing process. Results All the colonic perforation models in three pigs were established successfully. Endoscopic closure for acute colon perforation with two kinds of endoclips was technically successful in all 3 pigs. The mean time of the procedure with successive endoclip was less than that with the conventional endoclip (54.0 seconds VS 91.9 seconds, P<0.001), but the successful release rate of the successive endoclip was lower than that of the conventional endoclip without significant difference [62.5%(15/24) VS 14/16, P=0.17]. All the animals survived without infection and hemorrhage. Five perforations demonstrated signs of healing, whereas one closed with the novel successive endoclips failed to heal completely. Conclusion Endoscopic closure for acute colon perforations with novel successive endoclips is effective and safe. The novel successive endoclip has the advantage of saving time, but it needs to be further improved and perfected to satisfy the clinical need. Key words: Acute colonic perforation; Endoscopic closure; Metal clip
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