| Theme | Towards Standardization of ESD Procedures | |
|---|---|---|
| Title | Postoperative Management for Colorectal Endoscopic Mucosal Resection | |
| Publish Date | 2017/04 | |
| Author | Hiroyuki Takamaru | Endoscopy Division, National Cancer Center Hospital / Screening Center, National Cancer Center Hospital |
| Author | Yutaka Saito | Endoscopy Division, National Cancer Center Hospital |
| Author | Masayoshi Yamada | Endoscopy Division, National Cancer Center Hospital |
| Author | Taku Sakamoto | Endoscopy Division, National Cancer Center Hospital |
| Author | Takeshi Nakajima | Endoscopy Division, National Cancer Center Hospital |
| Author | Takahisa Matsuda | Endoscopy Division, National Cancer Center Hospital / Screening Center, National Cancer Center Hospital |
| [ Summary ] | Postoperative management is a very important aspect for colorectal endoscopic submucosal dissection (ESD). Adverse effects, such as perforation, sometimes result in a severe outcome, although they rarely occur. Safety is the most important aspect of colorectal ESD. In case an adverse effect develops, appropriate treatment should be formulated for patients. Recognition of delayed bleeding, which may occur in some cases despite improved technical procedure and devices, enables clinicians to provide a detailed pre‒operative explanation for patients and their family. Successful clip closure for intra‒operative perforation often makes it possible to complete the ESD procedure and manage patients without the need for emergency surgery. We also need to consider the possibility of delayed perforation as a rare complication. We should not hesitate to consult a surgeon in case of high-risk patients and decide on timely emergency surgery for the patients with serious conditions. | |