Use of the over-the-scope clip to treat massive bleeding at the transitional zone of the anal canal: a case series

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• 作者：Roy Soetikno ; MD ; MS¹ ; ² ; ³ ; ; Ravishankar Asokkumar ; MBBS ; MRCP² ; Davis Sim ; MD ; PhD¹ ; Tohru Sato ; MD¹ ; Tonya Kaltenbach ; MD ; MS¹
• 关键词：ATZ ; anal transitional zone ; OTSC ; over-the-scope clip ; SD ; standard deviation
• 刊名：Gastrointestinal Endoscopy
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：84
• 期：1
• 页码：168-172
• 全文大小：1387 K

文摘

Endoscopic treatment of anorectal bleeding can be challenging. We report use of the endoscopic over-the-scope clip (OTSC) to treat massive bleeding from the transitional zone of the anorectum. The aim of this retrospective study was to assess the clinical outcome and efficacy of the OTSC and to describe the technique of its use in acute severe bleeding occurring at the transitional zone of the anorectum.

Methods

We treated 5 consecutive patients (age range, 36-79 years, 5 men) with severe bleeding from the transitional zone of the anorectum caused by hemorrhoid therapy, digital trauma, and a Dieulafoy lesion. We analyzed the efficacy, safety, and outcome of endoscopic treatment using the OTSC.

Results

Primary hemostasis was successfully achieved in all the patients using a single OTSC. The OTSC deployment technique was adapted from the endoscopic band ligation of hemorrhoids. There was no immediate or late rebleeding. We observed that there were no adverse events from OTSC placement in the anorectum.

Conclusions

This case series provides evidence that OTSCs may be effective in controlling bleeding from the transitional zone of the anorectum. Although use of OTSCs for bleeding elsewhere in the GI tract has been described, this case series is the first to show its application in the transitional zone of the anorectum.