| Theme |
Training System and Risk Management for Endoscopic Submucosal Dissection (ESD) |
| Title |
Management and Prevention of Complications of Endoscopic Submucosal Dissection (ESD) |
| Author |
Tetsuya Inui |
Depertment of Endoscopy, Shizuoka Cancer Center Hospital |
| Author |
Hiroyuki Ono |
Depertment of Endoscopy, Shizuoka Cancer Center Hospital |
| Author |
Noriaki Hasuike |
Depertment of Endoscopy, Shizuoka Cancer Center Hospital |
| Author |
Hiroyuki Matsubayashi |
Depertment of Endoscopy, Shizuoka Cancer Center Hospital |
| Author |
Yuichiro Yamaguchi |
Depertment of Endoscopy, Shizuoka Cancer Center Hospital |
| Author |
Yosuke Otake |
Depertment of Endoscopy, Shizuoka Cancer Center Hospital |
| [ Summary ] |
The major intraoperative complications of ESD are bleeding and perforations. To avoid these complications, it is important to obtain the appropriate views of the submucosal layer and to manage the device exactly during the procedure. Intraoperative bleeding and perforations can be conservatively treated by endoscopic hemostasis or endoscopic closure by using endoclips. The major postoperative complications are bleeding, perforations, and stenosis. Coagulation of vessels at the ulcer floor, after ESD, is useful to prevent postoperative bleeding. To prevent stenosis, balloon bougie is necessary. Delayed perforation is rare, but may lead to serious complications, requiring surgical procedures. |