New closure technique for large mucosal defects after endoscopic submucosal dissection of colorectal tumors (with video)

Otake, Yosuke; Saito, Yutaka; Sakamoto, Taku; Aoki, Tetsuya; Nakajima, Takeshi; Toyoshima, Naoya; Matsuda, Takahisa; Ono, Hiroyuki

doi:10.1016/j.gie.2011.10.037

Cited by 69 publications

(52 citation statements)

References 19 publications

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“…It has been suggested that for defects smaller than the width of the open clip it should be clipped in a 'side to center' manner; when the defect is slightly larger than the width of the open clip, the diameter can be reduced by air suction. In case of large defects, the first clip is the most critical and a recent proposal for certain cases is to perform small incisions around to provide a better grip for the clip [95]. Combined methods are also a good approach for larger defects, for instances, hemoclips plus Endoloop [96,97], plus omental patch [93] or plus band ligation [98].…”

Section: Endoscopic Closure Methodsmentioning

confidence: 99%

Emergencies after endoscopic procedures

Rolanda

Caetano

Dinis-Ribeiro

2013

Best Practice & Research Clinical Gastroenterology

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Keywords:GI endoscopy adverse events GI emergencies Bleeding Haemorrhage Perforation Infection Embolization Diagnosis and management of severe complications a b s t r a c t Endoscopy adverse events (AEs), or complications, are a rising concern on the quality of endoscopic care, given the technical advances and the crescent complexity of therapeutic procedures, over the entire gastrointestinal and bilio-pancreatic tract. In a small percentage, not established, there can be real emergency conditions, as perforation, severe bleeding, embolization or infection. Distinct variables interfere in its occurrence, although, the awareness of the operator for their potential, early recognition, and local organized facilities for immediate handling, makes all the difference in the subsequent outcome. This review outlines general AEs' frequencies, important predisposing factors and putative prophylactic measures for specific procedures (from conventional endoscopy to endoscopic cholangio-pancreatography and ultrasonography), with comprehensive approaches to the management of emergent bleeding and perforation.

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Section: Endoscopic Closure Methodsmentioning

confidence: 99%

Emergencies after endoscopic procedures

Rolanda

Caetano

Dinis-Ribeiro

2013

Best Practice & Research Clinical Gastroenterology

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“…1 It should be emphasized, as indicated in the article, that we believe the closure technique suitable for mucosal defects from en bloc ESDs with an extremely low incidence of residual tumors rather than piecemeal EMRs. Although the effectiveness of the closure technique for large mucosal defects after ESDs has not yet been evaluated "in prospective studies involving larger numbers of patients," as we have recommended, negative data on the effectiveness of clipping after colonoscopic polypectomy previously reported by Shioji et al 2 should not be applied to such defects because of substantial differences in the sizes of mucosal defects between polypectomies and ESDs.…”

Section: Responsementioning

confidence: 95%

Closure of large mucosal defects after endoscopic submucosal dissection: an effective technique for preventing complications?

Matsushita

Tanaka

Fukata

et al. 2012

Gastrointestinal Endoscopy

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“…However, it adds considerable expense to the procedure and technical challenges including defect size may limit universal application of this technique currently [64]. Novel methods to facilitate clip closure of large defects, such as creating small defects to allow clip purchase on normal mucosa after colonic ESD, warrant further evaluation in randomized trials [65]. Further randomized studies to define the role of clip closure and explore application of novel 'spray on' adherent mechanical barriers [66], particularly in large resection defects, are required.…”

Section: Bleedingmentioning

confidence: 99%

Advanced endoscopic resection in the colon: recent innovations, current limitations and future directions

Tutticci

Bourke

2013

Expert Review of Gastroenterology & Hepatology

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The major health burden of colorectal cancer is reduced by colonoscopic polypectomy. The majority of polyps encountered are diminutive in size and easily removed; however, endoscopic removal of lesions >20 mm in size is also effective and safe. Techniques have progressed, advancing the boundaries of endoscopic therapy to include resection of circumferential lesions and selected submucosal invasive cancers. While there are cost and safety advantages over surgical management, specific limitations of endoscopic resection remain, chiefly bleeding, perforation and recurrence. Recent studies highlight the utility of risk stratification and demonstrate the effectiveness of endoscopic treatment of complications; however, strategies for prevention remain elusive. Prediction of submucosal invasive cancers through systematic assessment of lesion morphology and surface pattern is now established. Harnessing submucosal invasive cancer prediction and risk stratification allows a shift toward lesion-specific therapy, the next paradigm in the management of advanced colonic lesions.

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New closure technique for large mucosal defects after endoscopic submucosal dissection of colorectal tumors (with video)

Cited by 69 publications

References 19 publications

Emergencies after endoscopic procedures

Emergencies after endoscopic procedures

Closure of large mucosal defects after endoscopic submucosal dissection: an effective technique for preventing complications?

Advanced endoscopic resection in the colon: recent innovations, current limitations and future directions

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