Clin Endosc.  2015 Nov;48(6):534-541. 10.5946/ce.2015.48.6.534.

Endoluminal Closure of Colon Perforation with Endoscopic Band Ligation: Technical Feasibility and Safety in an In Vivo Canine Model

Affiliations
  • 1Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 2Department of Veterinary Surgery, Chungbuk National University College of Veterinary Medicine, Cheongju, Korea.
  • 3Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. thlee9@schmc.ac.kr
  • 4Department of Biomedical Engineering, Chungbuk National University College of Medicine, Cheongju, Korea.

Abstract

BACKGROUND/AIMS
Endoscopic band ligation (EBL) is an accepted method in the management of variceal bleeding; however, there is little evidence on the safety and feasibility of EBL for the closure of bowel perforation. In this study, we aimed to evaluate the technical feasibility and efficacy of EBL in iatrogenic colon perforation by using a canine model.
METHODS
We established an iatrogenic colon perforation model by using seven beagle dogs. Longitudinal 1.5- to 1.7-cm colon perforations were created with a needle knife and an insulated-tip knife, and the perforation was subsequently closed with EBL. During a 2-week follow-up period, the animals were carefully monitored and then euthanized for pathologic examination.
RESULTS
The EBL of iatrogenic colon perforations was successful in all dogs. The mean procedure time for EBL closure with one to three bands was 191.7 seconds, and there were no immediate complications. One animal was euthanized after 3 days because of peritonitis. There were no clinical and laboratory features of sepsis or peritonitis in the remaining six animals. On necropsy, we did not find any fecal peritonitis, pericolonic abscess formation, or transmural dehiscence at the perforation site. Histopathology demonstrated inflamed granulation tissue and scar lesions replaced by fibrosis.
CONCLUSIONS
EBL might be a feasible and safe method for the management of iatrogenic colon perforations in an in vivo model.

Keyword

Colon perforation; Endoscopic band ligation; Complication
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