Delayed perforation after endoscopic resection of a colonic laterally spreading tumor: A case report and literature review

Zhou, Ge-Yu-Jia; Hu, Jinlong; Wang, Sheng; Guo, Nan; Xiang, Liangzhong; Wang, Guoxin; Sun, Siyu; Guo, Jintao

doi:10.12998/wjcc.v8.i16.3608

Cited by 4 publications

(4 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Relative indications are those who do not meet the requirements for absolute or expanded indications, or open surgery cannot be recommended when taking into account the patient’s condition. Cases with gastrointestinal tumors are prone to intraoperative or postoperative perforation if the tumor originates from the deep muscularis propria layer or the muscle layer is damaged during ESD treatment, which has been described in many reports [ 3 , 7 , 8 ]. Similarly, endoscopic treatment of diverticulum-associated intestinal tumors is challenging due to the lack of a muscle layer [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Long-term endoscopic submucosal dissection with postoperative lung injury: a case report

Zhu

Hong

et al. 2021

BMC Surg

View full text Add to dashboard Cite

Background Endoscopic submucosal dissection (ESD) has been recognized as a safe and minimally invasive technique for the removal of early gastric cancer. Here, we describe a case of extended-duration ESD for a gastric tumor associated with intraoperative perforation and bleeding. Unfortunately, the patient developed acute lung injury (ALI) after the operation. Case presentation: A 72-year-old woman received ESD for a gastric tumor under general anesthesia. Preoperatively, endoscopic ultrasonography (EUS) showed a 3.1 × 3.5 cm hypoechoic, well-defined mass at the junction of the antrum and body of the stomach on the greater curvature, originating in the muscularis propria layer. During the ESD procedure, when the submucosal mass was stripped, it was found to be closely adhered to the muscular layer and serosa layer, and a full-thickness incision was performed. The abdominal cavity was gradually filled with carbon dioxide gas, and abdominal puncture was performed to reduce intra-abdominal hypertension (IAH). Because the mass adhered to the greater omentum and there was more bleeding during the operation, a long duration of hemostasis and suturing of the wound was required. The whole operation lasted nearly 9 h, and total blood loss was 800 ml. After surgery, acute lung injury was suspected, and the patient was sent to the intensive care unit (ICU) for further treatment. Conclusions The operation time of ESD and IAH caused by perforation are closely related to a poor prognosis. We should pay attention to the impact of operation time on patients and improve awareness regarding protecting important organ functions.

show abstract

Section: Discussionmentioning

confidence: 99%

Long-term endoscopic submucosal dissection with postoperative lung injury: a case report

Zhu

Hong

et al. 2021

BMC Surg

View full text Add to dashboard Cite

show abstract

“…Endoscopic closure of delayed perforations after colorectal endoscopic submucosal dissection (ESD) is challenging due to the fragility of the ulcer bed and the stiffness of the surrounding tissue 1 2 3 4 . The case presented here illustrates closure of an ulcer bed with delayed perforation after ESD by endoscopic mucosa-to-mucosa closure using a ring-string traction ( Fig.…”

Section: Figmentioning

confidence: 99%

Ring-string traction for successful endoscopic clip closure to treat delayed perforation of the ulcer bed after colorectal endoscopic submucosal dissection

Tsukida,

Kishida,

Imai

et al. 2024

Endoscopy

View full text Add to dashboard Cite

“…However, ESD has limited ability to strip deeply infiltrating esophageal lesions, which leads to a considerable risk of intraoperative perforation. Consequently, there is an urgent need to establish a new method to assess the surgical risk of ESD in patients before surgery ( 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

Combining non-invasive liquid biopsy and a methylation analysis to assess surgical risk for early esophageal cancer

Chen,

Li,

et al. 2024

Transl Cancer Res

View full text Add to dashboard Cite

Background While the widespread use of endoscopic submucosal dissection (ESD) has significantly reduced the incidence of early esophageal cancer (ESCA), the limited ability of ESD to strip deep infiltrating esophageal lesions results in a considerable risk of intraoperative perforation. Circulating-free DNA (cfDNA) is widely used in modern tumor screening due to its non-invasive detection capabilities. A methylation analysis offers vital insights into the condition and advancement of malignancies due to its unique positioning, such as a marker of cancer. This study investigated the potential of combining a non-invasive liquid biopsy technique, along with a methylation analysis, to assess the surgical perforation risk of ESCA patients. Methods In this study, we conducted an analysis of gene expression differences between stage I esophageal squamous carcinoma samples and healthy tissue samples using data from The Cancer Genome Atlas (TCGA) database. We also identified the genes associated with progression-free survival (PFS) in esophageal squamous carcinoma. Integrating the framework of the methylation analysis, we explored the methylated sites of these distinct genes. To refine this process, we used the Shiny Methylation Analysis Resource Tool (SMART) to conduct a comprehensive analysis of these sites. We then confirmed the stability of the methylation sites in different lesion conditions using methylation-specific quantitative polymerase chain reaction (MS-qPCR) with paraffin tissue samples collected after ESD. Results We analyzed RNA-sequencing data from 42 early stage ESCA patients and 17 controls, identifying 1,263 up-regulated and 460 down-regulated genes. Functional analyses revealed involvement in key pathways such as cell cycle regulation and immune responses. Furthermore, we identified 38 differentially expressed genes associated with PFS. Using SMART analysis, we found 217 hyper-methylated regions in 38 genes, suggesting potential early markers for ESCA. Validation experiments confirmed the reliability of 29 hyper-methylated regions in FFPE tissue samples and 6 regions in cfDNA. A LunaCAM model showed high accuracy [area under the curve (AUC) =0.89] in discriminating early ESCA. Integrated assessment of six highly methylated regions significantly improved predictive performance, with 90.56% sensitivity, highlighting the importance of combinatorial biomarker evaluation for early cancer detection. Conclusions This study established a novel approach that integrates non-invasive testing with a methylation analysis to assess the surgical risk of early ESCA patients. The significance of changes in methylation sites in relation to lesion status should not be underestimated, as they have the potential to offer vital insights for proactive risk assessments before surgery.

show abstract

Delayed perforation after endoscopic resection of a colonic laterally spreading tumor: A case report and literature review

Cited by 4 publications

References 27 publications

Long-term endoscopic submucosal dissection with postoperative lung injury: a case report

Long-term endoscopic submucosal dissection with postoperative lung injury: a case report

Ring-string traction for successful endoscopic clip closure to treat delayed perforation of the ulcer bed after colorectal endoscopic submucosal dissection

Combining non-invasive liquid biopsy and a methylation analysis to assess surgical risk for early esophageal cancer

Contact Info

Product

Resources

About