| Theme |
Countermeasures of adverse events in therapeutic endoscopy |
| Title |
Techniques and pitfalls of clip closure procedures for perforations and mucosal defects after colonic endoscopic dissection |
| Author |
Kenjiro Shigita |
Department of Endoscopy, Hiroshima City Asa Citizens Hospital |
| Author |
Shinji Nagata |
Departmemt of Gastrointestinal Medicine, Hiroshima City Asa Citizens Hospital |
| Author |
Yutaro Ogawa |
Departmemt of Gastrointestinal Medicine, Hiroshima City Asa Citizens Hospital |
| Author |
Yasutsugu Shimohara |
Departmemt of Gastrointestinal Medicine, Hiroshima City Asa Citizens Hospital |
| Author |
Hirosato Tamari |
Departmemt of Gastrointestinal Medicine, Hiroshima City Asa Citizens Hospital |
| Author |
Naoki Asayama |
Departmemt of Gastrointestinal Medicine, Hiroshima City Asa Citizens Hospital |
| Author |
Taiki Aoyama |
Departmemt of Gastrointestinal Medicine, Hiroshima City Asa Citizens Hospital |
| Author |
Akira Fukumoto |
Departmemt of Gastrointestinal Medicine, Hiroshima City Asa Citizens Hospital |
| Author |
Shinichi Mukai |
Departmemt of Gastrointestinal Medicine, Hiroshima City Asa Citizens Hospital |
| [ Summary ] |
We must master good management of perforations, which are the most important adverse events associated with endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for large colorectal tumors. Perforations made during EMR with snares are often large. However, mucosal defects of EMR are smaller than those from ESD. As a result, we can close mucosal defects completely by clipping from both edges to the center of mucosal defects. When a perforation occurs during ESD, we should create a margin by clipping safely and immediately and then close with clip. It is possible to close large mucosal defects after ESD completely by using a basic closure technic of clipping from both edges to the center and gradually narrowing the width of the defect. |