| Theme | Forefront of endoscopic treatment in early colorectal cancer | |
|---|---|---|
| Title | Prevention and management of colonoscopic complications | |
| Publish Date | 2003/11 | |
| Author | Hiroaki Ikematsu | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital |
| Author | Takahiro Fujii | Takahiro Fujii Clinic |
| Author | Takahiro Kouzu | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital |
| Author | Takahisa Matsuda | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital |
| Author | Kiwamu Hasuda | Department of Gastrointestinal Endoscopy, National Cancer Center Hospital |
| [ Summary ] | The main complications from endoscopic treatment are bleeding and perforation. Among 10,314 colonoscopic procedures performed at National Cancer Center Hospital and East Hospital, the rate of associated complications was 0.60%. Bleeding and perforations were seen in 0.54% and 0.06% respectively. Bleeding risk factors addressed before endoscopic treatment through interviews and compliance of the patient after treatment avoiding alcohol are of supreme importance. In cases of bleeding after polipectomy or EMR, clipping is a useful and safe treatment. In order to avoid perforations, improvements in technical skills is the most important aspect. Although perforations after endoscopic treatment are usually small and clearly recognized, surgical treatment has been used as the first choice. However, recent progress in endoscopic clipping sutures has increased the number of cases managed non-operatively. We have developed a new technique for endoscopic suture art for closing ulcerations after EMR using a two channel colonoscope, a loop snare and metallic clips. This new technique may be suitable for prevention of post operative bleeding and for treatment of perforations after colonoscopic procedures. |
|