| Theme | Perforation and it's Management in Endoscopy | |
|---|---|---|
| Title | Perforations Due to Endoscopic Submucosal Dissection for Gastric Tumors and Treatment to Avoid Occurrence | |
| Publish Date | 2010/02 | |
| Author | Kiyoaki Homma | Department of Therapeutic Endoscopy, Nihonkai General Hospital |
| Author | Toshihiro Suga | Department of Therapeutic Endoscopy, Nihonkai General Hospital |
| Author | Kazuomi Imaizumi | Department of Gastroenterology, Sakata Medical Center |
| Author | Eiji Hashizume | Department of Surgery, Nihonkai General Hospital |
| Author | Yoshiki Kuriya | Department of Surgery, Nihonkai General Hospital |
| [ Summary ] | The rate of perforations during endoscopic submucosal dissection (ESD) for gastric tumors has been reported to be under 5%. These complications were not considered to be serious and were treated with physical procedures only. However, critical cases have been reported occasionally. Perforation should be avoided during ESD treatment through careful operation of equipment. Suturing with clips and endoscopic systems supplying CO2 are effective measures to prevent perforations. Abdomens filled with gas leaking from perforations may also be treated with centesis. A system to provide care after ESD perforation should be formulated by surgeons. Endoscopists should always develop close relationships with surgeons. The surgical procedures should be conducted without hesitation if peritonitis can not be controlled in localized areas. Attention must be paid to avoid perforations during ESD treatment. On the other hand, the preparations for their occurrence should always be made. |
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