ArticleBMC surgery2025
Endoscopic purse-string suture technique for postoperative drain-related leakage management in gastrointestinal surgery.
Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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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Who cites it
1 citing paper in PubMed.
- Successful endoscopic drainage for gastropericardial fistula caused by a gastric conduit ulcer after esophagectomy.Clinical journal of gastroenterology · 2026Article
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Authors and funding
14 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAbdominal drain-associated fistulas (ADAFs) represent severe complications following gastrointestinal surgery, where conventional surgical reintervention carries invasiveness risks and extended recovery periods. This study evaluates the clinical efficacy and safety of endoscopic purse-string suturing for managing ADAFs.
methodsA retrospective cohort analysis included 41 patients with postoperative ADAFs treated at Shandong Second Medical University and external referral centers between January 2015 and June 2024.
resultsEndoscopic intervention achieved technical success in 87.8% (36/41) of cases, with clinical success observed in 63.4% (26/41). Subgroup analysis demonstrated significantly superior clinical outcomes in isolated ADAFs versus cases involving concurrent anastomotic disruption (90.0% vs. 39.1%, P = 0.001). Multivariate regression identified two independent predictors of reduced therapeutic efficacy: preoperative anastomotic stenosis (OR = 0.083, P = 0.041) and fistulous orifice diameter > 1 cm (OR = 0.039, P = 0.004). During 12-month follow-up, no mortality or fistula recurrence occurred. Postprocedural anastomotic stenosis developed in 4.9% (2/41) of patients, successfully managed through endoscopic balloon dilation (n = 1) and gastrointestinal stent placement (n = 1).
conclusionEndoscopic purse-string suturing emerges as a minimally invasive, safe, and effective therapeutic strategy for ADAFs, particularly demonstrating optimal clinical performance in isolated drain-associated fistulas with orifices ≤ 1 cm diameter.
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