| Theme |
Therapeutic Colonoscopy -- Recent Advances |
| Title |
Prevention and Management of Delayed Complications after the Endoscopic Resections for Colorectal Tumors |
| Author |
Toshio Uraoka |
Division of Endoscopy, National Cancer Center Hospital |
| Author |
Yutaka Saito |
Division of Endoscopy, National Cancer Center Hospital |
| Author |
Takahisa Matsuda |
Division of Endoscopy, National Cancer Center Hospital |
| Author |
Hisatomo Ikehara |
Division of Endoscopy, National Cancer Center Hospital |
| Author |
Daizo Saito |
Division of Endoscopy, National Cancer Center Hospital |
| Author |
Takahiro Fujii |
Takahiro Fujii Clinic |
| [ Summary ] |
Endoscopic resection of early colorectal tumors has become widely accepted and a relatively new treatment strategy, endoscopic submucosal dissection (ESD) in the colorectum, is a topic of considerable interest at the present time. The incidence of complications resulting from endoscopic resections, however, is on the increase with the primary delayed complications being bleeding and perforation. Out of 6,616 cases at the National Cancer Center Hospital over a three-year period from July 2002 to June 2005, delayed bleeding occurred in 24 or 0.36 % of the cases, but there were no instances of delayed perforation. The condition of the resected areas immediately following endoscopic piecemeal resections and ESD should be carefully examined because the increased use of these endoscopic procedures on large lesions has resulted in an increased incidence of delayed bleeding rates. It is important to establish adequate procedures for the prevention and management of complications in endoscopic treatments including provisions for informed patient consent. |