Prophylactic clip closure may reduce the risk of delayed bleeding after colorectal endoscopic submucosal dissection

Endoscopy International Open
Hideharu OgiyamaHiroyasu Iishi

Abstract

Endoscopic submucosal dissection (ESD) has a high en bloc resection rate and is widely performed for large superficial colorectal tumors, but delayed bleeding remains one of the most common complications of colorectal ESD. The aim of the present study was to evaluate the clinical efficacy of prophylactic clip closure of mucosal defects for the prevention of delayed bleeding after colorectal ESD. We enrolled consecutive patients with colorectal lesions between January 2012 and May 2017 in this retrospective study. In the early part of this period, post-ESD mucosal defects were not closed (non-closure group); however, from January 2014, post-ESD mucosal defects were prophylactically closed with clips when possible (closure group). The main outcome measured was delayed bleeding. Variables were analyzed using the chi-squared test, Fisher's exact test, or Student's t-test. Of 156 lesions analyzed, 61 were in the non-closure group and 95 in the closure group. Overall, delayed bleeding occurred in 5 cases (3.2 %). The delayed bleeding rate was 0 % (0/95) in the closure group and 8.2 % (5/61) in the non-closure group ( P  = 0.008). The mean procedure time for closure was 10.4 ± 4.6 min (range 3 - 26 min). We demonstrated that prophylac...Continue Reading

Citations

Apr 9, 2019·Clinical Endoscopy·Eun Ran Kim, Dong Kyung Chang
Jan 17, 2020·World Journal of Gastrointestinal Endoscopy·Satoshi KinoshitaToshio Uraoka
Apr 29, 2020·Surgical Endoscopy·Tak Lit Derek FungKam Hung Kwok
Jul 30, 2020·Expert Review of Gastroenterology & Hepatology·Yanqin XuXiao Lu Lin
Jul 3, 2021·Journal of Clinical Medicine·Yoshitsugu Misumi, Kouichi Nonaka
Sep 10, 2021·Gastrointestinal Endoscopy·Satoki ShichijoUNKNOWN Kansai Endoscopic Device Selection Conference in Kansai Research Group

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Methods Mentioned

BETA
dissection
X-ray
prophylactic clip

Software Mentioned

JMP

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