ABSTRACT
OBJECTIVE: Recently, a through-the-scope suturing (TTSS) system has received FDA approval and has been evaluated for closing mucosal defects postintervention. We hereby performed a systematic review and pooled meta-analysis of available studies to assess the safety and efficacy of this intervention. METHODS: We queried the following databases through April 26, 2023: Embase, MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science Core Collection. Endoscopists utilizing TTSS for the following reasons were included: endoscopic mucosal resection, endoscopic submucosal dissection, peroral endoscopic myotomy, perforation, fistula closure, and/or stent fixation. The outcomes assessed were technical success, primary clinical success (closure of defect without additional intervention), and overall clinical success (closure of defect with/without additional intervention). Random effects model with the DerSimonian Laird approach was used to report event rates expressed as proportions with a 95% CI. RESULTS: A total of 12 studies with 512 patients (mean age of 61.5 ± 18.4 y, 54.6% females) were included. The technical success rate was 96.0% (CI: 94.3%-97.7%). The primary clinical success rate was 74.8% (CI: 65.5%-84.1%). The overall clinical success rate was 95.4% (CI: 92.6-98.2%). Only 1 mortality case unrelated to intervention was reported. CONCLUSION: The TTSS appears safe and effective for closing mucosal defects after therapeutic endoscopic interventions. Further cost-effective studies should be performed comparing with endoclips for use in clinical settings.
Subject(s)
Adenocarcinoma/diagnosis , Colonic Neoplasms/diagnosis , Gastrointestinal Hemorrhage/etiology , Pancreatic Neoplasms/diagnosis , Spinal Neoplasms/diagnosis , Adenocarcinoma/complications , Adenocarcinoma/drug therapy , Adenocarcinoma/secondary , Aged , Antineoplastic Agents/therapeutic use , Biopsy , Colon/diagnostic imaging , Colon/pathology , Colonic Neoplasms/complications , Colonic Neoplasms/drug therapy , Colonic Neoplasms/secondary , Colonoscopy , Diagnosis, Differential , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Endosonography , Humans , Male , Pancreas/diagnostic imaging , Pancreas/pathology , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/pathology , Sacrum/diagnostic imaging , Spinal Neoplasms/drug therapy , Spinal Neoplasms/secondary , Tomography, X-Ray ComputedABSTRACT
Biliary obstruction is a rare presentation of abdominal aortic aneurysm (AAA). The most common symptoms of AAA are abdominal or back pain and limb ischaemia from thromboembolism. We report a case of a 67-year-old male who was diagnosed with obstructive jaundice secondary to an AAA. CT angiogram revealed compression of the common bile duct by the large AAA, causing diffuse intrahepatic and extrahepatic ductal dilatation. Surgical repair of the aortic aneurysm was successful, and patient's symptoms improved.
