{"title":"一种用于内镜乳头切除术中更安全、更快速缝合的新型夹子装置：对241例手术的回顾性研究","authors":"Kohei Takano, Kentaro Yamao, Takuya Ishikawa, Yoshihisa Takada, Yasuyuki Mizutani, Tadashi Iida, Kota Uetsuki, Takeshi Yamamura, Yoji Ishizu, Kazuhiro Furukawa, Takashi Honda, Masanao Nakamura, Hiroki Kawashima","doi":"10.1111/jgh.16963","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and Aim</h3>\n \n <p>Endoscopic papillectomy (EP) is a minimally invasive treatment for ampullary neoplasms. However, traditional endoscopic clips used for hemostasis and suturing during EP are often difficult to manipulate because of limitations in maneuverability. To address this issue, the efficacy of a novel clip was evaluated for its potential to improve suturing and reduce procedure difficulty after EP.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective study included 241 patients who underwent EP at Nagoya University Hospital between December 2004 and April 2024. Patients were divided into two groups: the conventional clip group (<i>n</i> = 184) and the novel clip group (<i>n</i> = 57). We compared the total clipping time, number of clips used, and incidence of adverse events between the two groups.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The total clipping time was significantly shorter in the novel clip group than in the conventional clip group (6.0 vs. 12.7 min, <i>p</i> < 0.01). The novel clip group also required fewer clips for suturing (3.9 vs. 5.0 clips, <i>p</i> < 0.01) and had fewer dislodged clips at the second look endoscopy (0.05 vs. 0.72 clips, <i>p</i> < 0.01). There was no significant difference in the delayed bleeding rate between the two groups (5.3% vs. 8.7%, <i>p</i> = 0.58).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The novel clip demonstrated superior performance in terms of reducing the procedure time, the number of clips used, and the incidence of clip dislodgement in suturing after EP. This offers a promising solution for improving procedural efficiency. In conclusion, the novel clip should be used in wound suturing after EP.</p>\n </section>\n </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 5","pages":"1238-1244"},"PeriodicalIF":3.7000,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Novel Clip Device for Safer and Faster Suturing in Endoscopic Papillectomy: A Retrospective Study of 241 Procedures\",\"authors\":\"Kohei Takano, Kentaro Yamao, Takuya Ishikawa, Yoshihisa Takada, Yasuyuki Mizutani, Tadashi Iida, Kota Uetsuki, Takeshi Yamamura, Yoji Ishizu, Kazuhiro Furukawa, Takashi Honda, Masanao Nakamura, Hiroki Kawashima\",\"doi\":\"10.1111/jgh.16963\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background and Aim</h3>\\n \\n <p>Endoscopic papillectomy (EP) is a minimally invasive treatment for ampullary neoplasms. However, traditional endoscopic clips used for hemostasis and suturing during EP are often difficult to manipulate because of limitations in maneuverability. To address this issue, the efficacy of a novel clip was evaluated for its potential to improve suturing and reduce procedure difficulty after EP.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This retrospective study included 241 patients who underwent EP at Nagoya University Hospital between December 2004 and April 2024. Patients were divided into two groups: the conventional clip group (<i>n</i> = 184) and the novel clip group (<i>n</i> = 57). We compared the total clipping time, number of clips used, and incidence of adverse events between the two groups.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The total clipping time was significantly shorter in the novel clip group than in the conventional clip group (6.0 vs. 12.7 min, <i>p</i> < 0.01). The novel clip group also required fewer clips for suturing (3.9 vs. 5.0 clips, <i>p</i> < 0.01) and had fewer dislodged clips at the second look endoscopy (0.05 vs. 0.72 clips, <i>p</i> < 0.01). There was no significant difference in the delayed bleeding rate between the two groups (5.3% vs. 8.7%, <i>p</i> = 0.58).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>The novel clip demonstrated superior performance in terms of reducing the procedure time, the number of clips used, and the incidence of clip dislodgement in suturing after EP. This offers a promising solution for improving procedural efficiency. In conclusion, the novel clip should be used in wound suturing after EP.</p>\\n </section>\\n </div>\",\"PeriodicalId\":15877,\"journal\":{\"name\":\"Journal of Gastroenterology and Hepatology\",\"volume\":\"40 5\",\"pages\":\"1238-1244\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-04-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Gastroenterology and Hepatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jgh.16963\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastroenterology and Hepatology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jgh.16963","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景与目的内镜下乳头切除术是一种治疗壶腹部肿瘤的微创方法。然而，由于可操作性的限制，用于EP期间止血和缝合的传统内镜夹通常难以操作。为了解决这个问题，我们评估了一种新型夹子的疗效，因为它有可能改善EP后的缝合和降低手术难度。方法回顾性研究2004年12月至2024年4月在名古屋大学医院接受EP治疗的241例患者。将患者分为两组：常规夹组（184例）和新型夹组（57例）。我们比较了两组的总夹夹时间、夹夹数量和不良事件的发生率。结果新型夹组的总夹时间明显短于传统夹组（6.0 min vs. 12.7 min, p < 0.01）。新型夹组还需要更少的夹来缝合（3.9个夹比5.0个夹，p < 0.01），并且在第二次内镜检查时更少的夹移位（0.05个夹比0.72个夹，p < 0.01）。两组延迟出血率差异无统计学意义（5.3%比8.7%,p = 0.58）。结论该新型夹在缩短EP术后缝合时间、减少夹的使用次数、减少夹脱位发生率等方面均有较好的效果。这为提高程序效率提供了一个有希望的解决方案。综上所述，该新型夹适合于EP术后创面缝合。
A Novel Clip Device for Safer and Faster Suturing in Endoscopic Papillectomy: A Retrospective Study of 241 Procedures
Background and Aim
Endoscopic papillectomy (EP) is a minimally invasive treatment for ampullary neoplasms. However, traditional endoscopic clips used for hemostasis and suturing during EP are often difficult to manipulate because of limitations in maneuverability. To address this issue, the efficacy of a novel clip was evaluated for its potential to improve suturing and reduce procedure difficulty after EP.
Methods
This retrospective study included 241 patients who underwent EP at Nagoya University Hospital between December 2004 and April 2024. Patients were divided into two groups: the conventional clip group (n = 184) and the novel clip group (n = 57). We compared the total clipping time, number of clips used, and incidence of adverse events between the two groups.
Results
The total clipping time was significantly shorter in the novel clip group than in the conventional clip group (6.0 vs. 12.7 min, p < 0.01). The novel clip group also required fewer clips for suturing (3.9 vs. 5.0 clips, p < 0.01) and had fewer dislodged clips at the second look endoscopy (0.05 vs. 0.72 clips, p < 0.01). There was no significant difference in the delayed bleeding rate between the two groups (5.3% vs. 8.7%, p = 0.58).
Conclusions
The novel clip demonstrated superior performance in terms of reducing the procedure time, the number of clips used, and the incidence of clip dislodgement in suturing after EP. This offers a promising solution for improving procedural efficiency. In conclusion, the novel clip should be used in wound suturing after EP.
期刊介绍：
Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.
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