clinendoКлиническая эндоскопияFilin’s Clinical endoscopy2415-7813"Global Media technology" Ltdclinendo-426Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESВнутрипросветное закрытие ятрогенной перфорации прямой кишкиЯковенкоВ. А.v.yakovenko@oberigclinic.comМедицинский центр «Универсальная клиника «Обериг»Russian Federation20100912202542837Copyright © Яковенко В.А., 20252025Яковенко В.А.Яковенко В.А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://clinendo.elpub.ru/jour/article/view/426

Ятрогенная перфорация прямой кишки - осложнение диагностической (0,016-0,2%) и лечебной (до 10,4%) колоноскопии. Тактика лечения такого осложнения предполагает консервативный и оперативный варианты. В статье представлены два случая эндоскопической резекции слизистой оболочки прямой кишки, осложнившихся ятрогенной перфорацией (1,2 см и 1,5 см). Дефекты кишки успешно закрыты внутрипросветно с помощью вращающегося эндоскопического клипатора.

ReferencesAhmad N.A, Kochman M.L, Long'W.B, Furth E.E, Ginsberg G.G. Efficacy, safety, and clinical outcomes of endoscopic mucosal resection: a study of 101 cases. Gastrointest Endosc 2002;55(3):390-6.Ahmad N.A, Kochman M.L, Long'W.B, Furth E.E, Ginsberg G.G. Efficacy, safety, and clinical outcomes of endoscopic mucosal resection: a study of 101 cases. Gastrointest Endosc 2002;55(3):390-6.Bechtold М., Szary N. Rashid F., Kilgore Т., Puli S., Diaz-Arias A., Antilion M. Delayed Colonic Perforation after ESD in a Patient with Ulcerative Colitis: A Case Report and Review of the Literature.Int J Gastroenterol 2009; 8 (2).Bechtold М., Szary N. Rashid F., Kilgore Т., Puli S., Diaz-Arias A., Antilion M. Delayed Colonic Perforation after ESD in a Patient with Ulcerative Colitis: A Case Report and Review of the Literature.Int J Gastroenterol 2009; 8 (2).Conio M, Ponchon T, Blanchi S, Filiberti R. Endoscopic mucosal resection. Am J Gastroenterol 2006; 101(3):653-63.Conio M, Ponchon T, Blanchi S, Filiberti R. Endoscopic mucosal resection. Am J Gastroenterol 2006; 101(3):653-63.Demling RH, Salvatierra О Jr, Belzer FO.Intestinal necrosis and perforation after renal transplantation. Arch Surg 1975; 110(3):251-3.Demling RH, Salvatierra О Jr, Belzer FO.Intestinal necrosis and perforation after renal transplantation. Arch Surg 1975; 110(3):251-3.Endoscopic closure of acute iatrogenic perforations during diagnostic and therapeutic endoscopy in the gastrointestinal tract using metallic clips: A literature review/В Mangiavillano, P.Viaggi, E.Masci //Journal of Digestive Diseases 2010; 11; 12-18.Endoscopic closure of acute iatrogenic perforations during diagnostic and therapeutic endoscopy in the gastrointestinal tract using metallic clips: A literature review/В Mangiavillano, P.Viaggi, E.Masci //Journal of Digestive Diseases 2010; 11; 12-18.Fujishiro M, Yahagi N, Nakamura M, Kakushima N, Kodashima S, Ono S, Kobayashi K, FlashimotoT, Yamamichi N, Tateishi A, Shimizu Y, Oka M, Ogura K, KawabeT, Ichinose M, Omata M. Successful outcomes of a novel endoscopic treatment for Gl tumors: endoscopic submucosal dissection with a mixture of high-molecular-weight hyaluronic acid, glycerin, and sugar. Gastrointest Endosc 2006;63(2):243-9.Fujishiro M, Yahagi N, Nakamura M, Kakushima N, Kodashima S, Ono S, Kobayashi K, FlashimotoT, Yamamichi N, Tateishi A, Shimizu Y, Oka M, Ogura K, KawabeT, Ichinose M, Omata M. Successful outcomes of a novel endoscopic treatment for Gl tumors: endoscopic submucosal dissection with a mixture of high-molecular-weight hyaluronic acid, glycerin, and sugar. Gastrointest Endosc 2006;63(2):243-9.Ikehara FI, Fu Kl, Itoi T, Fujii T. Transcutaneous monitoring of partial pressure of carbon dioxide during endoscopic submucosal dissection of early colorectal neoplasia with carbon dioxide insufflation: a prospective study. Surg Endosc. 2010 Feb;24(2):343-52.Epub 2009 Jun 11.Ikehara FI, Fu Kl, Itoi T, Fujii T. Transcutaneous monitoring of partial pressure of carbon dioxide during endoscopic submucosal dissection of early colorectal neoplasia with carbon dioxide insufflation: a prospective study. Surg Endosc. 2010 Feb;24(2):343-52.Epub 2009 Jun 11.Ince MN, Elliott DE. Immunologic and molecular mechanisms in inflammatory bowel disease. Surg Clin North Am 2007;87(3):681-96.Ince MN, Elliott DE. Immunologic and molecular mechanisms in inflammatory bowel disease. Surg Clin North Am 2007;87(3):681-96.Katz S, Talansky A, Kahn E. Recurrentfree perforation in gastroduodenal Crohn's disease. Am J Gastroenterol 1983;78( 1 1 ):722-5.Katz S, Talansky A, Kahn E. Recurrentfree perforation in gastroduodenal Crohn's disease. Am J Gastroenterol 1983;78( 1 1 ):722-5.Keisei Taku K, Sano Y, Yoshida S. Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan. J Gastroenterol 2007; 22:1409Keisei Taku K, Sano Y, Yoshida S. Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan. J Gastroenterol 2007; 22:1409Lee T.H, Hsueh P.R, Yeh W.C, Wang H.P, Wang T.H, Lin J.T. Lowfrequency of bacteremia after endoscopic mucosal resection. Gastrointest Endosc 2000;52(2):223-5.Lee T.H, Hsueh P.R, Yeh W.C, Wang H.P, Wang T.H, Lin J.T. Lowfrequency of bacteremia after endoscopic mucosal resection. Gastrointest Endosc 2000;52(2):223-5.Mangiavillano B, Viaggi P, Masci E.Endoscopic closure of acute iatrogenic perforations during diagnostic and therapeutic endoscopy in the gastrointestinal tract using metallic clips: A literature review. Journal of Digestive Diseases 2010; 11; 12-18Mangiavillano B, Viaggi P, Masci E.Endoscopic closure of acute iatrogenic perforations during diagnostic and therapeutic endoscopy in the gastrointestinal tract using metallic clips: A literature review. Journal of Digestive Diseases 2010; 11; 12-18O'Brien TS, Garrido MC, Dorudi S, Collin J. Delayed perforation of the colon following colonoscopic biopsy. Br J Surg 1993;80(9): 1204.O'Brien TS, Garrido MC, Dorudi S, Collin J. Delayed perforation of the colon following colonoscopic biopsy. Br J Surg 1993;80(9): 1204.Ono H. Endoscopic submucosal dissection for early gastric cancer. Chin J Dig Dis 2005;6(3): 119-21.Ono H. Endoscopic submucosal dissection for early gastric cancer. Chin J Dig Dis 2005;6(3): 119-21.Orringer RD. Coller JA. Veidenheimer MC. Spontaneousfreeperforation of the small intestine. Dis Colon Rectum 1983;26(5):323-6.Orringer RD. Coller JA. Veidenheimer MC. Spontaneousfreeperforation of the small intestine. Dis Colon Rectum 1983;26(5):323-6.Raju GS, Ahmed I, Xiao SY et al. Controlled trial of immediate endoluminal closure of colon perforation in a porcine model by use of a novel clip device. Gastrointest Endosc 2006; 64: 989-97.)Raju GS, Ahmed I, Xiao SY et al. Controlled trial of immediate endoluminal closure of colon perforation in a porcine model by use of a novel clip device. Gastrointest Endosc 2006; 64: 989-97.)Rieder F, Brenmoehl J, Leeb S, Sch Imerich J, Rogler G. Wound healing and fibrosis in intestinal disease. Gut 2007;56(1): 130-9.Rieder F, Brenmoehl J, Leeb S, Sch Imerich J, Rogler G. Wound healing and fibrosis in intestinal disease. Gut 2007;56(1): 130-9.Saito Y, Fukuzawa M, Matsuda T, Fukunaga S, Sakamoto T, Uraoka T, Nakajima T. Endoscopic submucosal dissection (ESD) for colorectal tumors. Dig. Endosc. 2009; 21: S7-S12.Saito Y, Fukuzawa M, Matsuda T, Fukunaga S, Sakamoto T, Uraoka T, Nakajima T. Endoscopic submucosal dissection (ESD) for colorectal tumors. Dig. Endosc. 2009; 21: S7-S12.Shimizu Y, Kato M, Yamamoto J, Nakagawa S et al. Endoscopic clip application for closure of esophageal perforations caused by EMR. Gastrointest Endosc 60(4):636-9 (2004)Shimizu Y, Kato M, Yamamoto J, Nakagawa S et al. Endoscopic clip application for closure of esophageal perforations caused by EMR. Gastrointest Endosc 60(4):636-9 (2004)Taku K, Sano Y, Fu K, Saito Y et al. Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan. J Gastroenterol Hepatol 22(9)4409-14 (2007)Taku K, Sano Y, Fu K, Saito Y et al. Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan. J Gastroenterol Hepatol 22(9)4409-14 (2007)Technology status report evaluation. Endoscopic mucosal resection. Gastrointest Endosc 2000;52(6):860-3.Technology status report evaluation. Endoscopic mucosal resection. Gastrointest Endosc 2000;52(6):860-3.Toyonaga Т., Man-i М., Fujita Т., East JE et al. Retrospective study of technical aspects and complications of endoscopic submucosal dissection for laterally spreading tumors of the colorectum / Endoscopy. 2010 Sep;42(9):714-22. Epub 2010 Aug 30Toyonaga Т., Man-i М., Fujita Т., East JE et al. Retrospective study of technical aspects and complications of endoscopic submucosal dissection for laterally spreading tumors of the colorectum / Endoscopy. 2010 Sep;42(9):714-22. Epub 2010 Aug 30Tsunada S, Ogata S, Fujimoto K. Endoscopic closure of perforations caused by EMR in the stomach by application of metallic clips. Gastrointest Endosc 2003; 57:948Tsunada S, Ogata S, Fujimoto K. Endoscopic closure of perforations caused by EMR in the stomach by application of metallic clips. Gastrointest Endosc 2003; 57:948Warshaw AL, Welch JP, Ottinger LW. Acute perforation of the colon associated with chronic corticosteroid therapy. Am J Surg 1976; 131 (4):442-6.Warshaw AL, Welch JP, Ottinger LW. Acute perforation of the colon associated with chronic corticosteroid therapy. Am J Surg 1976; 131 (4):442-6.Yoshida N, Wakabayashi N, Kanemasa K, Sumida Y, Hasegawa D, Inoue K, Morimoto Y, Kashiwa A, Konishi H, Yagi N, Naito Y, Yanagisawa A, Yoshikawa T. Endoscopic submucosal dissection for colorectal tumors: technical difficulties and rate of perforation. Endosc 2009; Sep;41(9):758-61.Epub 2009 Sep 10.Yoshida N, Wakabayashi N, Kanemasa K, Sumida Y, Hasegawa D, Inoue K, Morimoto Y, Kashiwa A, Konishi H, Yagi N, Naito Y, Yanagisawa A, Yoshikawa T. Endoscopic submucosal dissection for colorectal tumors: technical difficulties and rate of perforation. Endosc 2009; Sep;41(9):758-61.Epub 2009 Sep 10.Yoshikane H, Hidano H, Sakakibara A, Ayakawa T, Mori S, Kawashima H, Goto H, Niwa Y. Endoscopic repair by clipping of iatrogenic colonic perforation. Gastrointest Endosc 1997; 46: 464-466Yoshikane H, Hidano H, Sakakibara A, Ayakawa T, Mori S, Kawashima H, Goto H, Niwa Y. Endoscopic repair by clipping of iatrogenic colonic perforation. Gastrointest Endosc 1997; 46: 464-466Yoshikane H, Hidano H, Sakakibara A, Mori S, Takahashi Y, Niwa Y, Goto H. Endoscopic resection of laterally spreading tumours of the large intestine using a distal attachment. Endoscopy 1999;31(6):426-30.Yoshikane H, Hidano H, Sakakibara A, Mori S, Takahashi Y, Niwa Y, Goto H. Endoscopic resection of laterally spreading tumours of the large intestine using a distal attachment. Endoscopy 1999;31(6):426-30.Yutaka Saito Y, Matsuda T Kikuchi I Ikehara H, Uraoka I Uccessful endoscopic closures of colonic perforations requiring abdominal decompression after endoscopic mucosal resection and endoscopic submucosal dissection for early colon cancer. Dig Endosc; 19: S34-S39.Yutaka Saito Y, Matsuda T Kikuchi I Ikehara H, Uraoka I Uccessful endoscopic closures of colonic perforations requiring abdominal decompression after endoscopic mucosal resection and endoscopic submucosal dissection for early colon cancer. Dig Endosc; 19: S34-S39.

The authors declare that there are no conflicts of interest present.