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At least 289 records · Page 16Linked to original sources
PubMed2000

Endovascular coil embolization of residual or recurrent aneurysms after surgical clipping.

PURPOSE: Treatment of residual or recurrent aneurysms after surgical clipping is a challenge and most surgeons prefer to avoid a second surgical attempt. We present treatment of 4 residual or recurrent aneurysms after surgical clipping with electrolytically detachable coils. MATERIAL AND METHODS: In 3 of 4 patients, recurrent aneurysms were diagnosed with angiography 2 months, 5 years and 14 years after surgery, although the domes of the aneurysms were opened following clipping during the surgery. In the 4th patient, an early postoperative angiogram revealed filling of a residual aneurysm secondary to the incomplete neck clipping. Guglielmi detachable coils were used to occlude the residual or recurrent aneurysm. RESULTS: The endovascular approach was successful in all patients and the control angiograms showed complete obliteration of the aneurysms with no recanalization. CONCLUSION: The endovascular approach is a good treatment option for patients in whom complete obliteration of the aneurysm cannot be achieved by surgical clipping. Opening of the aneurysm sac after clipping does not necessarily preclude aneurysm regrowth from a neck remnant proximal to the clip.

Adult↗
PubMedDate not supplied

The dynamic variation of several important taxane content in post-harvest Taxus chinensis clippings.

The dynamic variations of several important taxanes, taxol, baccatin III (B-III), 1-acety-5,7,10-deacetyl-baccatin I (DAB-I) and baccatin VI (B-VI), were investigated in post-harvest clippings of Taxus chinensis. The clippings were preserved over 20 days at two different temperatures (4 degrees C and room temperature), or by cuttage in the light and in the dark, or promptly dried. The accumulation of taxol in needles of the clippings was found increase in the initial stages of the stored period and then decreased gradually. The maximum accumulation of taxol occurred in the case of cold storing (4 degrees C) at day 3, doubling the data on the day when the biomass was harvested. In contrast, in the cases of cold storage and cuttage the contents of the other three taxanes showed a sharp decrease at the beginning and then an increase from 3 to 6 days, and subsequently a drop until day 20. The similar variation of taxane contents was not found in the needles of immediately dried clippings as well as in the stem samples of clippings. These results indicated that the content variation of taxol and related taxanes of post-harvest clippings was related to the manner of preservation, timing and plant tissue. Moreover, the mechanism of the fluctuation of the taxane contents in post-harvest clippings is discussed, in particular taxol biosynthesis in response to mechanical wounding of harvest.

Alkaloids↗
PubMed1999

Dynamic localization of CLIP-170 to microtubule plus ends is coupled to microtubule assembly.

CLIP-170 is a cytoplasmic linker protein that localizes to plus ends of microtubules in vivo. In this study, we have characterized the microtubule-binding properties of CLIP-170, to understand the mechanism of its plus end targeting. We show that the NH2-terminal microtubule-interacting domain of CLIP-170 alone localizes to microtubule plus ends when transfected into cells. Association of CLIP-170 with newly-formed microtubules was observed in cells microinjected with biotinylated tubulin, used as a tracer for growing microtubules. Using in vitro assays, association of CLIP-170 with recently polymerized tubulin is also seen. Cross-linking and sedimentation velocity experiments suggest association of CLIP-170 with nonpolymerized tubulin. We conclude from these experiments that the microtubule end targeting of CLIP-170 is closely linked to tubulin polymerization.

Centrosome↗
PubMed2001

Autonomic dysreflexia and primary afferent sprouting after clip-compression injury of the rat spinal cord.

Spinal cord injury leads to many forms of autonomic dysfunction including autonomic dysreflexia, a condition involving recurrent episodes of paroxysmal hypertension and associated bradycardia. This hypertension may reach intensities that are life-threatening. We investigated autonomic dysreflexia and the sprouting of central processes of primary afferent neurons (a potential mechanism for autonomic dysreflexia) in a clinically-relevant calibrated clip-compression model of spinal cord injury in the rat. Autonomic dysreflexia was induced by colon distension in the conscious rats 2 weeks after severe (50-g) clip compression injury of the spinal cord at the 4th thoracic segment. The central arbor of small-diameter primary afferent fibers in laminae III-VII of the spinal cord dorsal horn was also assessed at 2 weeks after cord injury by quantitative morphometry, using calcitonin gene-related peptide as a marker. In response to colon distension, arterial pressure increased by 41 +/- 3 mmHg from a resting value of 109 +/- 4 mmHg, and heart rate decreased by 124 +/- 13 beats/min from a value of 515 +/- 16 beats/min (n = 7). Minimal locomotor function was recovered by these rats: by 2 weeks after injury they attained scores of only 3.1 +/- 1.3 on the Basso, Beattie and Bresnahan scale. Histopathology of the clip-compression lesion site in the cord consisted of extensive central necrosis extending several segments rostral and caudal to the lesion. Quantitative measures of the small-diameter afferent arbors revealed significant increases in area ranging from 20-27% in thoracolumbar segments caudal to the injury (n = 5) in comparison to sham-injured rats (n = 6). A second study was done to assess the impact of severity of injury on the relationship between the size of the primary afferent arbors and autonomic dysreflexia. At 2 weeks after milder (20-g) clip injury at T4, rats exhibited responses to colon distension that were not those associated with autonomic dysreflexia (n = 5). Arterial pressure increased by only 16 +/- 3 mmHg and heart rate tended to increase (+19 +/- 12 beats/min). These rats attained a locomotor score of 7.1 +/- 0.4 by 2 weeks. The lesions at the injury site also contained necrosis and mild cavitation within the gray matter. No change in the small-diameter afferent arbor was detected at 2 weeks after the 20-g clip injury at T4 (n = 6 rats). These findings suggest that after severe but not mild clip compression injury of the spinal cord, sprouting of the afferent component of the spinal reflex are contributes to the development of autonomic dysreflexia. Neither dysreflexia, nor changes in the afferent arbor size occurred after mild cord injury. This clinically relevant clip compression cord injury model, studied more frequently for locomotor function, is excellent for investigating mechanisms for the development of autonomic dysreflexia and strategies for its prevention.

Animals↗
PubMed1997

Blunted renal responses to atrial natriuretic peptide and its reversal by unclipping in one-kidney, one clip Goldblatt hypertensive rats.

OBJECTIVE: To evaluate the hypotensive and renal effects of atrial natriuretic peptide (ANP) in one-kidney, one clip Goldblatt hypertensive rats with and without renal arterial stenosis. METHODS: The one-kidney, one clip hypertensive rats were divided into four groups: untreated time control, ANP-infused, unclipped and unclipped plus ANP-infused. The changes in blood pressure, glomerular filtration rate and renal excretory function were determined during intravenous vehicle and ANP infusions while the renal arterial clip was in place or removed acutely. One-kidney normotensive rats infused with ANP were used for comparison. RESULTS: In one-kidney control rats, ANP infusion at doses of 0.15, 0.30 and 0.45 microg/kg per min decreased the mean blood pressure from 121 +/- 4 to 108 +/- 5 (9%, P < 0.05), 104 +/- 5 (17%, P < 0.05) and 89 +/- 4 mmHg (25%, P < 0.05), respectively. There was no significant change in glomerular filtration rate. However, the absolute sodium excretion rate increased significantly, by 343 +/- 66, 770 +/- 91 and 786 +/- 78%, respectively. A comparable magnitude of increase in the fractional sodium excretion was noted. In one-kidney, one clip hypertensive rats, the similar three doses of ANP infusion reduced blood pressure from 179 +/- 7 to 162 +/- 8 (8%, P < 0.05), 146 +/- 9 (17%, P < 0.05) and 138 +/- 8 mmHg (22%, P < 0.05), respectively. A slight but insignificant increase in renal function was observed during ANP infusion. Removal of the renal arterial clip reduced blood pressure rapidly and caused a transient increase in renal function. Subsequent infusion of ANF further reduced blood pressure but increased sodium and water excretion markedly. CONCLUSION: There is a blunted natriuresis and diuresis in response to ANP infusion in one-kidney, one clip hypertensive rats. Surgical removal of the clip from the renal artery restores the natriuretic and diuretic effects of ANP.

Animals↗
PubMed1990

Surgical and electrophysiological observations during clipping of 134 aneurysms with evoked potential monitoring.

Somatosensory evoked potentials (SEPs) were monitored during 113 operations for the clipping of 134 cerebral aneurysms. Changes in peak latency and amplitude of early cortical SEP as well as central conduction time were evaluated. In 58 cases surgical occlusion of arterial vessels or other events occurred, and in 17 of these cases such events were associated with SEP changes or loss. Arterial occlusions resulted from temporary clipping of a feeding blood vessel (22), accidental clipping of a vessel (12), and intentional permanent vessel occlusion (8). A total SEP loss was seen in 2 cases of accidental vessel occlusion and in 6 cases of temporary vessel clipping. Significant SEP changes were found in 6 patients with temporary clipping, and once each with retraction of the cerebellum, retraction of the middle cerebral artery, and after intentional permanent vessel occlusion. Response to these changes included reapplication of aneurysm clips, repositioning of retractors, or removal of temporary clips. Stable SEP signals during 13 cases allowed the surgeon to proceed with the surgical course. Despite the limitations of SEP monitoring in certain anatomical locations, it has been found to be helpful in the operative management of some cases such as multilobed aneurysms of the middle cerebral artery, giant aneurysms, trapping procedures, and procedures requiring temporary vessel occlusion.

Adolescent↗
PubMed1990

A comparative study in opening and closing pressures of cerebral aneurysm clips.

Modern aneurysm clips with newer metallurgic properties and state-of-the-art designs have evolved through the years. Regretfully, manufacturers are still not required to provide product information regarding clip strength, and when such information is supplied, there is no interbrand consistency to how it is obtained. This experiment compares the closing pressures of 5 commonly used brands of aneurysm clips: Yasargil, Sugita, Sundt-Kees, Vari-Angle McFadden, and Heifetz. Interclip comparison is also made of opening pressures, that is, the arterial pressure required to open an aneurysm clip. Findings show a distinct difference in closing forces among these brands of aneurysm clips. The study of opening forces indicates that the important factors determining clip release or displacement were the failure of the clip to cross the vessel completely and intrinsic characteristics of the vascular wall.

Constriction↗
PubMed1997

Interlocking-clipping technique for giant aneurysms of the internal carotid artery: technical case report.

OBJECTIVE AND IMPORTANCE: Direct clipping of giant intracranial aneurysms is sometimes difficult. A unique technique using multiple fenestrated clips for closing a giant aneurysm is described. CLINICAL PRESENTATION: A 65-year-old woman presented with a 10-month history of headache and gait disturbance. Cerebral angiography disclosed an unruptured giant aneurysm of the right internal carotid artery. INTERVENTION: Surgical exposure confirmed the presence of a giant aneurysm with the splaying and incorporation of the parent artery and a number of perforating arteries originating from the dome. Four angled and three straight fenestrated clips were applied in tandem to the aneurysm to reconstruct the parent artery and preserve the perforating vessels. Through their blades and heads, the closely arranged clips were successfully interlocked. CONCLUSION: This "interlocking-clipping" technique is a modification of the tandem clipping technique. The aim of this approach is to enhance closing pressure and allow a more stable "seating" of the clips in giant cerebral aneurysms.

Aged↗
PubMed1999

Angioscopy-assisted aneurysm clipping.

OBJECTIVE: To test the concept that endovascular angioscopy can assist surgical intracranial aneurysm clipping by providing an endoluminal view of the aneurysm-parent vessel complex. METHODS: A carotid bifurcation aneurysm was surgically created in a dog at the lingual artery origin. A balloon catheter was inflated proximal to the aneurysm to block proximal blood flow and allow endoluminal visualization. A flexible angioscope connected to a video monitoring system and to a high-intensity light source was then advanced within the catheter lumen and positioned immediately distal to the catheter tip. The aneurysm neck was clipped, and the clip was repositioned several times along the neck, with or without distal parent vessel compromise. Each time, the endovascular image on the monitor was interpreted by an observer blinded to the position of the clip. Clip position and image interpretation were communicated independently to a third person, who analyzed the correlation between them. RESULTS: Angioscopy allowed clear visualization of the extent of aneurysm neck occlusion (complete, incomplete, residual "dog ear") after clip application, as well as the presence or absence of distal parent vessel compromise. Aneurysm neck configuration, size, presence of thrombus, and suture line definition were depicted. Critical structures external to the aneurysm-parent vessel complex were transilluminated by the high-intensity lamp. CONCLUSION: Although acknowledged as the treatment of choice for intracranial aneurysms, surgical exclusion can be accompanied by significant morbidity related to perforator occlusion, parent artery compromise, and/or persistent residual aneurysm. The availability of a device allowing visualization of an aneurysm from an endoluminal perspective theoretically could reduce the incidence of these complications. Angioscopy has the potential to become a useful adjunct during intracranial aneurysm clipping because it provides real-time endoluminal viewing of the aneurysm-distal parent vessel complex, which is sometimes obscured to the surgeon.

Angioscopy↗
PubMed2006

Acute effects of the superoxide dismutase mimetic tempol on split kidney function in two-kidney one-clip hypertensive rats.

OBJECTIVE: To investigate the acute effects of the superoxide dismutase mimetic 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (tempol) on split kidney function, and renal haemodynamics, in two-kidney, one-clip (2K1C) hypertensive rats. METHODS: Three weeks after clipping, or the sham procedure, the effects of intravenous tempol (200 micromol/kg per h) were evaluated on thiobutabarbital anaesthetized Sprague-Dawley rats. RESULTS: Mean arterial pressure (MAP; 152 +/- 3 versus 122 +/- 3 mmHg, P < 0.001), plasma renin activity (28.7 +/- 3.0 versus 9.5 +/- 0.6 ng/ml per h, P < 0.001) and urinary 8-iso-prostaglandin F2alpha excretion (124 +/- 4 versus 92 +/- 10 pmol/24 h, P = 0.003) were significantly elevated in 2K1C rats compared with sham. Tempol reduced MAP by 15 +/- 1% compared with baseline (P < 0.001) in 2K1C rats. In clipped kidneys, tempol increased the glomerular filtration rate (GFR; +50 +/- 15% from baseline) and the effective renal plasma flow (ERPF; +37 +/- 13%, from baseline), and reduced renal vascular resistance (RVR; -32 +/- 6% from baseline) compared with saline-treated controls (P < 0.05). In non-clipped kidneys, tempol reduced RVR (-24 +/- 5% from baseline) compared with saline-treated controls (P = 0.001). In sham-operated rats, tempol produced a modest reduction in MAP (-8 +/- 2% from baseline, P = 0.003), but did not significantly affect renal haemodynamics or function. CONCLUSION: Tempol reduced MAP and RVR in both clipped and non-clipped kidneys of 2K1C hypertensive rats. In addition, tempol increased ERPF and GFR in the clipped kidney. These findings suggest important roles for superoxide in the regulation of renal haemodynamics during the early maintenance phase of renovascular hypertension.

Animals↗
PubMed2005

Control of the renal artery and vein with the nonabsorbable polymer ligating clip in hand-assisted laparoscopic donor nephrectomy.

BACKGROUND: The large and variable size of the renal vein has prompted most surgeons to select linear stapling devices to secure the vein during laparoscopic donor nephrectomy. Although effective, these stapling devices have a potential for misfire. Use of the nonabsorbable polymer ligating (NPL) clip during laparoscopic donor nephrectomy provides increased graft vessel length compared with the stapling device, and the NPL clip has a locking mechanism which may increase security compared with standard titanium clips. The objective of this study was to evaluate the safety and efficacy of the NPL clip for control of the renal artery and vein during hand-assisted laparoscopic donor nephrectomy (HALDN). METHODS: A retrospective chart review of 50 consecutive HALDN patients was conducted where two parallel NPL clips were used to control both the renal artery and vein. Information collected included demographic data, operative and postoperative data, and complications. RESULTS: Mean donor age was 33.4 years and body mass index was 25.8 kg/m2. Mean operative time was 266.0 min, mean hospital stay was 3.2 days, and mean warm ischemia time was 123.3 seconds. There were no transfusions, open conversions, or complications related to use of the NPL clip. A US 16,300 dollars disposable cost savings was seen during this 1-year period alone. CONCLUSIONS: The NPL clip was 100% safe and effective in controlling the renal artery and vein during HALDN, allowed for additional vessel length, and resulted in a disposable cost savings of US 362 dollars per patient.

Adult↗
PubMed2005

Evaluation of predictive value of CLIP, Okuda, TNM and JIS staging systems for hepatocellular carcinoma patients undergoing surgery.

BACKGROUND: An accurate staging system is required to assess hepatocellular carcinoma (HCC) patients in order to benefit from hepatic resection before surgery. Cancer of the Liver Italian Program (CLIP) score was considered to be better than the Okuda staging system to predict survival. Japan Integrated Staging Score (JIS score) includes tumor, nodes, metastases (TNM) stage and Child-Pugh grade as a new staging system for HCC. The purpose of the present paper was to compare the CLIP, Okuda, TNM and JIS staging systems for HCC patients undergoing surgery. METHODS: From 1991 to 1995, 599 patients undergoing hepatic resection for HCC from four medical centers in Taiwan were evaluated. All patients were classified by Okuda, CLIP, TNM and JIS systems. Factors associated survivals were analyzed. RESULTS: There was no statistical difference in survival between CLIP 0 and 1 patients, or among CLIP 2-4 patients. The prognostic validation of the Okuda and CLIP scoring systems in discriminating survival in HCC patients undergoing surgery was not satisfied. The TNM system was successful in predicting survival for HCC patients undergoing surgery. The JIS score could also differentiate survivals for those patients except for JIS 3. By multivariate analysis, age > or =60 years old, serum albumin <3.5 g/dL, tumor size >5 cm and TNM stage were associated with survival. CONCLUSION: Both the Okuda and CLIP systems are not superior to TNM staging for HCC patients who undergo surgical resection. Whether JIS score is feasible for those patients with advanced HCC needs further evaluation.

Adult↗
PubMed2004

The effects of reducing the length of canine teeth in sucking pigs by clipping or grinding.

OBJECTIVE: To provide production data that would support or discount current teeth clipping practices in sucking pigs. DESIGN: Intervention study of 207 litters of pigs on a commercial farm. PROCEDURE: Litters were assigned to one of three interventions undertaken at 1 day of age: clipped using hand-operated side cutter pliers, ground using a battery-operated grinder or left intact. The effects of the intervention on weaning weight, preweaning mortality, facial lesions, gum damage and arthritis in litters of pigs were recorded, as was the incidence of udder damage of the sows. Weight gain and facial damage postweaning of pigs within each intervention group were recorded. The cost:benefit of each intervention was determined. RESULTS: Average weaning weight of pigs whose teeth were clipped was higher than of those whose teeth were ground but not of those with intact teeth. Clipping resulted in fewer preweaning deaths than both unclipped and ground litters due to fewer overlays. The incidence and severity of face scarring was higher in unclipped litters than clipped and ground litters. Treatment had no effect on face scars at weaning, udder damage, post-treatment fostering, time of preweaning deaths or postweaning weight gain. There was an additional labour cost of 6 cents per pig with teeth clipping. CONCLUSION: This study supports teeth clipping of sucking pigs because there are welfare, production and financial benefits including reduced facial damage and preweaning mortality.

Animals↗
PubMed2002

The effect of coat clipping on thermoregulation during intense exercise in trotters.

The aim of this study was to study the physiological, especially thermoregulatory, responses during intense exercise in the clipped horse compared to the horse with winter coat. Six Standardbred trotters were studied before and after clipping. They performed an inclined incremental high intensity treadmill exercise test and were monitored during recovery. The clipped horse differed significantly (ANOVA) during exercise as compare to coated: less increase in central venous blood temperature, higher skin surface temperature, greater difference skin to ambient temperature and higher rate of nonevaporative heat loss. The clipped horse had significantly lower total cutaneous evaporative heat loss from walk to end of peak exercise and a shorter time for recovery for the respiratory rate using a paired t test. The clipped horse showed a tendency (P = 0.059) to decreased oxygen uptake during the stepwise increase in workload. We concluded that the clipped horse experienced less strain on the thermoregulatory system due to an enhanced heat loss. Some clipped horses in the study showed a more efficient power output; future studies with emphasis on respiration and oxygen demand are needed to explain this.

Analysis of Variance↗
PubMed1994

Quality ratings for frequency-shaped peak-clipped speech.

Peak clipping is a common form of distortion in hearing aids and can reduce the subjective quality of the amplified speech. In a typical hearing aid, frequency-response shaping precedes symmetric peak clipping. The effect of peak clipping on speech quality ratings was therefore studied using sentence test materials that were processed using different frequency response contours and then clipped at different clipping thresholds. The quality of each processed sentence was rated on a ten-point scale by normal-hearing subjects. The experimental results indicate that the clipping threshold, and the interaction of the frequency-response shaping with the clipping threshold, significantly affect speech quality. It is also shown that the distortion effects on speech quality can be modeled by a distortion index computed from the magnitude-squared coherence of the speech-processing system in response to a shaped-noise input signal.

Acoustic Stimulation↗
PubMed1984

Pathogenesis of one-kidney, one-clip hypertension in rats after renal denervation.

This study examines the role of the renal nerves in the chronic and early developmental stages of one-kidney, one-clip (1K-1C) Goldblatt hypertension. Groups of uninephrectomized Sprague-Dawley rats underwent renal artery constriction with a clip of an internal diameter of 0.23 mm (groups 1 and 3) or 0.40 mm (groups 2 and 4) to produce severe or moderate hypertension. Two weeks later, groups 1 and 2 were subjected to renal denervation and groups 3 and 4 were denervated 6 and 7 wk after clipping, respectively. In all four groups, hypertension remained unchanged during the subsequent 2 wk after denervation. To study further the effects of renal denervation during the early onset of hypertension, groups 5, 6, and 7 received the smaller (0.23 mm) clip after uninephrectomy. Groups 5 and 6 were renal denervated immediately before clipping; group 7 was not denervated. In groups 6 and 7 the renin-angiotensin system was blocked with a continuous infusion of the converting-enzyme inhibitor captopril for 24 h before and 15 days after clipping. In group 5, renal denervation did not prevent a prompt and severe rise in the systolic blood pressure. In groups 6 and 7, infusion of captopril prevented the hypertension only during the first 4 days after clipping; at no time was there a difference in the systolic blood pressure curves of groups 6 and 7 during or after captopril infusion. These data demonstrate that regardless of the severity and duration of hypertension, renal denervation failed to attenuate either the development or the maintenance of 1K-1C Goldblatt hypertension in the rat. Thus the present results fail to provide support for the concept that the renal nerves modulate the hypertension in this experimental model.

Animals↗
PubMed2002

Neuropsychological sequelae of patients treated with microsurgical clipping or endovascular embolization for anterior communicating artery aneurysm.

BACKGROUND AND PURPOSE: While microsurgical clipping has been the choice of treatment for anterior communicating artery (ACoA) aneurysm, endovascular embolization is increasingly popular for treating intracranial aneurysms. Previous studies showed that in terms of mortality (i.e., death) and morbidity (i.e., functional outcome, independent living, rebleeding) rates, the clinical outcomes of coil embolization for intracranial aneurysms are as good as or even better than those of surgical clipping. However, little is known about the impact of these treatments on the cognitive functions of those survived after the treatment. Thus, the present study is designed to examine the cognitive deficits of patients treated with either surgical clipping or coil embolization. METHOD: Eighteen patients with a ruptured ACoA aneurysm were recruited. Half of them had undergone surgical clipping and the other half had endovascular embolization. Standardized neuropsychological tests were employed to assess their memory, executive function, motor ability, language and visual perceptual abilities. RESULTS: The performance of the patients was in general poorer than that of the normal control subjects on tests of verbal memory, flexible thinking, ability to resist interference and motor control. However, in terms of severity, the patients who received surgical clipping demonstrated more severe impairment than those had endovascular embolization on these cognitive domains. In addition, while 33% of patients in the clipping group showed impairments on memory and executive function, no patient in the embolization group demonstrated these impairments. CONCLUSIONS: Patients with ACoA aneurysm demonstrated impaired verbal memory, executive function and motor abilities while their language and visual perception abilities remained relatively intact. However, when comparing the effect of treatment choice on the cognitive functions of these patients, the present results favored the coil embolization as the patients treated with coil embolization demonstrated significantly fewer severe cognitive deficits than patients who had undergone surgical clipping.

Adult↗
PubMedDate not supplied

Is intraluminal clip application an appropriate treatment for iatrogenic gastric perforation?

BACKGROUND: The standard treatment of iatrogenic perforation has been an urgent operation. Recently, endoscopic clip application was recommended particularly for iatrogenic perforations. This study was designed to investigate the usage of surgical clips for gastric perforations. METHOD: Forty male rats were allocated to four groups. Following a midline laparotomy, a 5-mm gastrotomy was made at the fundic part of the stomach and through this ostomy a pre-pyloric perforation was created in all groups. In group I, the perforation site was closed with polypropylene sutures. In group II, the perforation site was closed extraluminally by vascular surgical clips. In group III, the perforation site was closed intraluminally by the same number of clips. In group IV, control group, the perforation site was left open. The animals were sacrificed on the 4th postoperative day. The healing of the perforation site was evaluated by the bursting pressure and the hydroxyproline content of the suture line. RESULTS: Measurements revealed no differences in bursting pressure and hydroxyproline levels between the intraluminal clip application group (group III) and the group in which the perforation site was left open (group IV) (p > 0.05). Higher bursting pressures and hydroxyproline levels were observed in groups I and II compared to control group (p < 0.05). CONCLUSIONS: These results suggest that gastric perforations are not strengthened by intraluminal clip application. Further detailed clinical studies are necessary in order to conclude that intraluminal clip application is an appropriate treatment for iatrogenic perforation.

Animals↗