Line‐assisted complete closure for a large mucosal defect after colorectal endoscopic submucosal dissection decreased post‐electrocoagulation syndrome

Abstract

This study suggests that LACC can effectively reduce the incidence of PECS, although further large-scale studies are warranted.

Feasibility of Underwater Clip Closure for Large Mucosal Defects after Colorectal Endoscopic Submucosal Dissection

“…Clip closure of the mucosal defect located at the sharp flexure is basically difficult [10,11]. Insufflation makes the angle of the flexure sharper, leading to a failed closure [11].…”

“…Clip closure of the mucosal defect located at the sharp flexure is basically difficult [10,11]. Insufflation makes the angle of the flexure sharper, leading to a failed closure [11]. The underwater condition, however, seems to flatten the angle of the flexure, resulting in complete closure of the defect even though the defect is originally located at the precipitous flexure.…”

“…Procedure time was measured from the start to fill the lumen with physiological saline until complete closure was achieved. Delayed adverse events were defined as in previous reports [5,10,11].…”

“…To avoid such delayed adverse events, prophylactic complete closure of the mucosal defect after C-ESD has been attempted by some operators, and the possibility that it may decrease delayed adverse events has been reported [6][7][8][9][10][11]. Conventional clip closure has been used most frequently and is an effective technique, but the size of the mucosal defect is limited, resulting in incomplete closure in several cases [6][7][8].…”

“…Lineassisted complete closure (LACC), first reported in 2016 [9][10][11], was a useful technique for addressing large mucosal defects. LACC could completely close most mucosal defects, but it was somewhat complicated, and a few incomplete closures occurred when the lesion was located at the flexure [11]. Thus, the development of a simpler, more effective closure technique is required.…”