| Theme | Current Endoscopic Treatment for Colorectal Tumors | |
|---|---|---|
| Title | Prevention and Management of Complications for Colorectal ESD | |
| Publish Date | 2014/02 | |
| Author | Hakuei Shinhata | Department of Gastroenterology, Jichi Medical University School of Medicine |
| Author | Hironori Yamamoto | Department of Gastroenterology, Jichi Medical University School of Medicine |
| Author | Yoshikazu Hayashi | Department of Gastroenterology, Jichi Medical University School of Medicine |
| Author | Hiroyuki Sato | Department of Gastroenterology, Jichi Medical University School of Medicine |
| Author | Yoshimasa Miura | Department of Gastroenterology, Jichi Medical University School of Medicine |
| Author | Yuji Ino | Department of Gastroenterology, Jichi Medical University School of Medicine |
| Author | Aya Kitamura | Department of Gastroenterology, Jichi Medical University School of Medicine |
| Author | Keijiro Sunada | Department of Gastroenterology, Jichi Medical University School of Medicine |
| [ Summary ] | In April 2012, insurance coverage for colorectal endoscopic submucosal dissection (ESD) was approved in Japan. Since then colorectal ESD has become generally accepted. However, ESD techniques for colorectal tumors is more difficult than those used for gastric tumors because of the anatomical and histological characteristics of the colorectal wall. This procedure also has a higher potential for complications. The main complications associated with colorectal ESD are bleeding and perforations. Pre-coagulation techniques are very effective to minimize the risk of bleeding. Bloodless operative fields provided by ESD lead to reduced risk of perforation. Ideas to prevent complications related to bleeding and perforations are presented. Unsuccessful closure with clip placement or delayed perforation after ESD require surgical procedures to prevent severe peritonitis. | |