| Theme | Colorectal endoscopic submucosal dissection | |
|---|---|---|
| Title | Complications related to endoscopic submucosal dissection (ESD) of colon and rectum and risk management procedures | |
| Publish Date | 2006/11 | |
| Author | Sumio Tsuda | Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| [ Summary ] | Introduction : In order to determine the frequency of complications related to ESD of the colon and rectum, and to know what is required for safe procedures, an inquiry using questionnaires was carried out at thirty institutions. Results : The frequency of perforations was 6.0 % (82 / 1,367 cases) and those with bleeding 2.3 % (32 / 1,367 cases), both of which were considered high. The frequency of perforations was very high. Before starting ESD the following factors should be considered : (a) characteristics of anatomy and histology of the colon and rectum along with technique for ESD, and precautions to prevent complications should be implemented, (b) ESD practioners should be familiar with endoscopic apparatus and other treatment devices, (c) they should receive ongoing training for the procedures, (d) operators should select cases considering their own technical capabilities, (e) they should exercise extreme caution, (f) they must maintain their concentration, (g) they should aim to develop technical improvements, (h) new endoscopic apparatus and other treatment devices suitable for ESD should be developed, (i) appropriate cases, with clear indications for ESD must be determined. By developing guidelines and training systems for ESD, in consideration of the above mentioned points, safer ESD techniques will be established, and this procedure will become more popular. |
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