Endoscopic tissue shielding method with polyglycolic acid sheets and fibrin glue to cover wounds after colorectal endoscopic submucosal dissection (with video)

Taking Warfarin with Heparin Replacement and Direct Oral Anticoagulant Is a Risk Factor for Bleeding after Endoscopic Submucosal Dissection for Early Gastric Cancer

“…Tsuji et al [34] reported that polyglycolic acid sheets and fibrin glue protected artificial ulcer after ESD and might reduce the rate of bleeding after gastric ESD. Maruoka et al [35] reported that vonoprazan could be used for gastric ulcers as a new and strong acid inhibitor, and might induce artificial ulcer healing after gastric ESD, as an alternative to a proton pump inhibitor.…”

Risk factors for bleeding after gastric endoscopic submucosal dissection: a systematic review and meta-analysis

“…Single studies found preventive coagulation of visible vessels as a beneficial measure in reducing PPB, and 2 recent studies suggested that polyglycolic acid sheets with fibrin glue may reduce PPB after gastric and colonic ESD. 72,85 However, interventions like preprocedural PPIs, mucoprotectives, and routine closure with clips or artery clipping were not found to be of benefit. Endoscopic suturing of large mucosal defects after gastric and colonic ESD were also reported in a single-arm study and no adverse events were seen.…”

Endoscopic submucosal dissection

“…Early pilot studies are ongoing to develop techniques that reduce the risks of postoperative adverse events after ESD (eg, delayed bleeding, perforation) including endoscopic suturing of ESD defects 115 and the use of polyglycolic acid sheets and fibrin glue to "shield" defects. 116 ESD techniques have been applied to the endoscopic resection of neoplasia arising in the submucosa and muscularis propria, including full-thickness resections. 117 In some series, these deeper resections have been facilitated by the variant technique of endoscopic submucosal tunnel dissection.…”