title: Endoscopic closure of experimental iatrogenic gastric fundus perforation using over-the-scope clips in a surviving canine model.
abstract: OBJECTIVE
  To evaluate the effectiveness and outcomes of endoscopic closure of a gastric fundus perforation using over-the-scope clips (OTSCs) system in a surviving canine model.
  
  
  METHODS
  Gastric fundus perforations (20-mm diameter) were created by an endoscopic needle-knife in six dogs. The perforations then were closed by the OTSC system. Gastroscopy was performed to evaluate the postoperative perforation healing every week. The animals were sacrificed 4 weeks later to examine the possible intraperitoneal complications, and the healing of the perforation was examined histopathologically.
  
  
  RESULTS
  The gastric fundus perforations could primarily be closed using one OTSC in each experimental dog, and the mean time of the procedure was 17.3 ± 7.6 min (9-26 min). All animals survived without postoperative complications. The OTSC retention was observed in one dog at the end of 4 weeks, and the apparent foreign-body reaction was examined pathologically.
  
  
  CONCLUSIONS
  Our surviving animal study demonstrated that the OTSC clip system could reliably close gastric fundus perforations without complications.
authors.affiliation: Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Xiu Li
authors.initials: XL
authors.lastname: Zhang
authors.forename: Gang
authors.initials: G
authors.lastname: Sun
authors.forename: Ping
authors.initials: P
authors.lastname: Tang
authors.forename: Ru Gang
authors.initials: RG
authors.lastname: Zhang
authors.forename: Yun Sheng
authors.initials: YS
authors.lastname: Yang
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D005260:Female; D005748:Gastric Fundus / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D020699:Gastroscopes; D005773:Gastroscopy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D007049:Iatrogenic Disease; D016896:Treatment Outcome; D058106:Wound Closure Techniques / Q000009:adverse effects / Q000295:instrumentation*; D014945:Wound Healing
keywords: endoscopic closure; gastric fundus perforation; over-the-scope clip (OTSC); survival