| Theme |
<Comprehensible explanation> "JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection" |
| Title |
Complications |
| Author |
Toshihiro Nishizawa |
Division for Research and Development of Minor Invasive Treatment, Cancer Center, Keio University School of Medicine / Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine |
| Author |
Naohisa Yahagi |
Division for Research and Development of Minor Invasive Treatment, Cancer Center, Keio University School of Medicine |
| [ Summary ] |
The typical complications during colorectal endoscopic treatment are perforation and hemorrhage. The perforation rates during endoscopic treatment are reported to be 0-0.8 % and 2-10.7 % for EMR and ESD, respectively. The postoperative hemorrhage rates are reported to be 1-1.8 % and 0.7-7.1 % for EMR and ESD, respectively. When perforation occurs during the procedure, clipping must be performed. If a complete suture is available, there is a high possibility of avoiding operation by the administration of antibiotics and fasting. Furthermore, it is necessary to comprehensively select the timing of emergency surgery in cooperation with surgeons. For hemorrhage associated with endoscopic treatment, clipping or coagulation using the tip of a knife or a hemostat is applicable. To avoid delayed perforation due to hypercoagulation, minimum electrocoagulation should be applied. |