Clinical outcomes of endoscopic submucosal dissection for colorectal tumors: a large multicenter retrospective study from the Hiroshima GI Endoscopy Research Group

Prophylactic Clip Closure Clarified: The Question Is Not Whether to Clip, But When

“…1 Bowel cancer screening whether via fecal immunochemical testing, flexible sigmoidoscopy, or primary colonoscopy, decreases the risk of future colorectal cancer significantly, and colonoscopy is the final common pathway in screening to remove polyps and prevent cancer 1,2 ; however, despite this effectiveness, it has also become evident that colonoscopy is not perfect and cancers occur after a "clear" colonoscopy at a rate of between 2.5% and 8.7% of the total cancers diagnosed, depending on the method used to calculate and the population. 3,4 The suggested mechanisms for postcolonoscopy colorectal cancer include incomplete colonoscopy, missed lesions, incomplete polypectomy, and rapidly growing lesions. 5 These mechanisms apply both to cancers occurring after a clear colonoscopy, and to metachronous cancers occurring after a colorectal cancer is resected, which occurs after up to 3% of surgical resections.…”

“…H emostatic clips are established as effective to control active colonic bleeding, 1 to prevent delayed perforation after endoscopic mucosal resection (EMR)-induced deep mural injury, 2 and to close free perforations occurring during EMR 3 and endoscopic submucosal dissection. 4 A common use of clips has been prophylactic closure of colorectal polypectomy sites, with intent to prevent delayed hemorrhage. This use of clips is controversial, because efficacy data on prophylactic clipping are mixed and clips are expensive.…”

Prevention and management of spouting bleeding during endoscopic submucosal dissection for large subpedunculated‐type colonic tumor

“…Endoscopic submucosal dissection (ESD) is a reliable method for treating superficial colorectal tumors; however, it is technically more difficult and requires more experience than gastric ESD, because of difficulties associated with endoscope operability and the anatomical features of the colorectal region, including the presence of folds/flexures, bending of the intestinal tract, and the thinness of the intestinal wall . Main accidental complications during colorectal ESD are perforation and bleeding .…”

Clinical usefulness of the S-O clip during colorectal endoscopic submucosal dissection in difficult-to-access submucosal layer

“…Colorectal endoscopic submucosal dissection (ESD) is a method that can be used for en bloc resection, regardless of the size and form of the lesion [1][2][3][4][5][6][7][8][9]. However, poor operability of the scope or the existence of submucosal fibrosis prevents successful ESD.…”