Closure with clips to accelerate healing of mucosal defects caused by colorectal endoscopic submucosal dissection

Surgical Endoscopy
Taro OsadaSumio Watanabe

Abstract

Most mucosal defects that occur with endoscopic submucosal dissection (ESD) can be closed completely using endoscopic clips. However, benefits of such closure in wound healing are unknown. A randomized controlled study evaluated the efficacy of closure with clips compared with no closure. Twenty-eight patients who had undergone ESD were randomly divided into two groups: closure (n = 14) and non-closure groups (n = 14). In the closure group, the mucosal defect resulting from ESD was closed using endoscopic clips. Four weeks after ESD, defects in both groups were observed by colonoscopy. Efficacy was based on change in the area of the defect, percentage of complete healing in each group, and complications. Data were analyzed for 26 of the 28 patients (13, closure group; 13, non-closure group). All tumors were resected en bloc by ESD without bleeding or perforation. In the closure group, the area of the defect just after ESD was 677 ± 306 mm(2) (mean ± SD) as determined by the size of the removed lesion and had decreased to 2.17 ± 4.51 mm(2) at 4 weeks after ESD (reduction, 99.7 %), but in the non-closure group that area was 790 ± 221 mm(2) and had decreased to 27.42 ± 25.72 mm(2) at 4 weeks post-ESD (reduction, 96.2 %). The reduc...Continue Reading

References

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Citations

Jul 19, 2016·Gastrointestinal Endoscopy·Qi-Sheng Zhang
Jul 14, 2020·Expert Review of Gastroenterology & Hepatology·Shria KumarJeffrey H Lee
Apr 29, 2020·Surgical Endoscopy·Tak Lit Derek FungKam Hung Kwok
Oct 14, 2017·United European Gastroenterology Journal·Toshihiro NishizawaNaohisa Yahagi
Sep 9, 2020·Endoscopy International Open·Alexandra MackAlan Moss

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