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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(01): E76-E80
DOI: 10.1055/a-1012-1838
Original article
Owner and Copyright © Georg Thieme Verlag KG 2020

Complete closure versus simple closure for perforations during colorectal endoscopic submucosal dissection

Satoshi Kinoshita
1   Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Gunma University, Tokyo, Japan
,
Toshihiro Nishizawa
1   Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Gunma University, Tokyo, Japan
2   Department of Gastroenterology and Hepatology, International University of Health and Welfare Mita Hospital, Gunma University, Tokyo, Japan
,
Ai Fujimoto
1   Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Gunma University, Tokyo, Japan
,
Hideki Mori
1   Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Gunma University, Tokyo, Japan
,
Yuichiro Hirai
1   Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Gunma University, Tokyo, Japan
,
Yoshihiro Nakazato
1   Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Gunma University, Tokyo, Japan
,
Masahiro Kikuchi
1   Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Gunma University, Tokyo, Japan
,
Toshio Uraoka
3   Department of Gastroenterology and Hepatology, Gunma University, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

submitted 06 June 2019

accepted after revision 05 August 2019

Publication Date:
08 January 2020 (online)

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Abstract

Background and study aims The efficacy of complete closure versus simple closure for perforations during endoscopic submucosal dissection (ESD) has never been evaluated. We evaluated the efficacy of complete closure and simple closure for perforations and muscular layer injuries incurred during ESD.

Patients and methods Thirty-four consecutive patients who underwent “complete closure” or “simple closure” for correction of perforations and muscular layer injuries during colorectal ESD were enrolled in this study. Complete closure was performed by the mucosa-submucosa clip closure method using only conventional endo-clips. For simple closure, endo-clips are placed just for perforation or muscular layer injury, while leaving any mucosal defects open.

Results Among the 15 patients in the complete closure group, eight developed perforations and seven developed muscular layer injuries. Among the 19 patients in the simple closure group, six developed perforations and 13 developed muscular layer injuries during the ESD procedure. There were no statistically significant differences between the two groups in inflammatory reactions, adverse events, or length of the hospital stay.

Conclusion Complete closure and simple closure for perforations and muscular layer injuries during ESD seem to have similar efficacy. While simple closure for a perforation during ESD seems sufficient, further study will be required to confirm our results.

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2020; 52(02): 159-159
DOI: 10.1055/a-1045-6212

 

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