ArticleBMC cancer2025
Clinical application of "purse-string suture" under endoscope in the treatment of refractory postoperative intestinal anastomotic fistula.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Endoscopic purse-string suture technique for postoperative drain-related leakage management in gastrointestinal surgery.BMC surgery · 2025Article
- Endoscopic Management of Postsurgical Complications.Visceral medicine · 2025Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostoperative intestinal anastomotic fistula (PIAF) remains a challenging complication with suboptimal outcomes under conventional therapies. This study evaluates the safety and efficacy of endoscopic purse-string suturing (EPS) in managing refractory PIAF and identifies prognostic predictors.
methodsA retrospective analysis of 55 patients with refractory PIAF treated via EPS (2015-2024) was conducted. Technical success was defined as endoscopic fistula closure, while clinical success required radiologic/endoscopic healing confirmation. Logistic regression models identified risk factors for poor outcomes.
resultsEPS achieved a technical success rate of 87.3% (52/55) and a clinical success rate of 63.6% (35/55). Subgroup analyses revealed no significant differences between in-house and external referrals (clinical: 61.1% vs. 64.9%, P = 0.786; technical: 88.9% vs. 81.1%, P = 0.463). Preoperative ostomy status correlated with higher clinical success (92.3% vs. 54.8%, P = 0.014), though technical success was comparable (92.3% vs. 85.7%, P = 0.533). Multivariate analysis identified delayed intervention (> 2 months post-diagnosis) (OR = 0.027, 95% CI: 0.002-0.410) and Pre-existing anastomotic stricture (OR = 0.43, 95% CI: 0.004-0.507) as independent risk factors for poor prognosis. Complications included anastomotic stricture (3.6%, managed endoscopically) and transient diarrhea (1 case). No mortality or recurrence occurred during 12-month follow-up.
conclusionsThis study establishes endoscopic purse-string closure as a safe and effective minimally invasive intervention for refractory post-implantation anastomotic fistulas, particularly when implemented during early disease progression. Therapeutic optimization through time-sensitive intervention and selective stoma creation demonstrates significant potential for enhancing clinical outcomes in complex fistula management.
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