| Theme | Management of large colorectal polyp --Indication and technique of endoscopic treatment | |
|---|---|---|
| Title | Clipping before and after endoscopic resection of large colorectal tumors | |
| Publish Date | 2000/11 | |
| Author | Haruhiko Okamoto | Department of Surgery, School of Medicine, Faculty of Medicine, Niigata University |
| Author | Toshiyuki Yamazaki | Department of Surgery, School of Medicine, Faculty of Medicine, Niigata University |
| Author | Tsuneo Iiai | Department of Surgery, School of Medicine, Faculty of Medicine, Niigata University |
| Author | Takeyasu Suda | Department of Surgery, School of Medicine, Faculty of Medicine, Niigata University |
| Author | Katsuyoshi Hatakeyama | Department of Surgery, School of Medicine, Faculty of Medicine, Niigata University |
| [ Summary ] | The purpose of endoscopic clipping is to avoid bleeding after endoscopic resection of pedunculated and semipedunculated tumors, and facilitate the healing of the ulcer after endoscopic resection of sessile tumors. We constric the neck of pedunculated tumors for hemostasis, using clips, before resection. We close the mucosal defect, using clips, after mucosal resection of sessile tumors, especially superficial spreading tumors. Clips should be handled carefully and exactly, and the direction of the suture line should lie in a right angle to the bowel axis, if possible. Also, to facilitate the adaptation of clipped mucosa, injury to the mucosa from the high frequency power supply should be kept to a minimum. We use a low voltage, high frequency power supply, when we intend to close the mucosal defect after resection of sessile tumors. Although clipping is a difficult maneuver, it has no other demerits and therefore is a significant method to reinforce the positive effects of endoscopic resection of large colorectal tumors. |
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