| [ Summary ] |
The main complications associated with endoscopic demucosation of the colon are bleeding and perforation. Critical to the prevention of complications are an accurate evaluation of whether or not resection is indicated. The establishment of a favorable therapeutic environment, the employment of an appropriate technique for resection, and provisions for sufficient postoperative rest are necessary. Major of complications can be avoided by strict adherence to these principles. The use of an indwelling snare for pedunculated lesions, a viperous snare to prevent perforation, or the aggressive use of resection after local injections, for non-surface type lesions, are also effective means of preventing complications. The physician should have a good understanding of the techniques for using resection, and their importance in selecting the optimal procedure for the patient. In addition, there are several countermeasures and techniques which are worth trying in order to prevent complications from occurring postoperatively. Clipping is the most expedient and reliable technique capable of being used endoscopically, in the event of bleeding. Clips are therefore an indispensable tool for treatment. Even when perforation is suspected, the execution of appropriate therapy may avoid the need for laparotomy. |