The efficacy and safety of prophylactic closure for a large mucosal defect after colorectal endoscopic submucosal dissection

( 最大 2000 件 )
URI http://shark.lib.kagawa-u.ac.jp/kuir/metadata/27647
タイトル
The efficacy and safety of prophylactic closure for a large mucosal defect after colorectal endoscopic submucosal dissection
ファイル
内容記述

Abstract

Endoscopic submucosal dissection (ESD) is not a common treatment for colorectal neoplasms because of its technical difficulties and has a higher incidence of complication. In particular, perforation is one of the severe complications and these patients require surgical intervention. However, whether prophylactic closure after colorectal ESD prevents perforation and other complications is not known. In the present study, we assessed the efficacy and safety of prophylactic closure for a large mucosal defect after colorectal ESD using a conventional clip and over-the-scope clip (OTSC) system. From April 2010 to December 2012, 68 patients with colorectal tumors were treated with ESD. The prohylactic closure was indicated for patients with excessive coagulation in the muscularis propria or larger resection size. The closure group reduced the peritoneal inflammatory reaction and abdominal symptoms without increasing complications. The closure group also had a significantly lower WBC count (post operative day 1), CRP (post operative day 4) and abdominal pain after colorectal ESD compared to the non-closure group. Perforation occurred in 1 case, and postoperative bleeding in 2 cases, with only 1 bleeding case needing an emergency endoscopy in the non-closure group. One perforation case needed emergency surgery because the endoscopic treatment was ineffective. Without increasing adverse effects, the prophylactic closure efficiently reduced the inflammatory reaction and abdominal symptoms of colorectal ESD in patients with large superficial colorectal neoplasms.

(医博甲608)

著者
著者 藤原 新太郎
著者(ヨミ) フジハラ シンタロウ
著者(別表記) Fujihara Shintaro
掲載誌
Oncology Reports
掲載誌(別表記)
Oncol Rep.
30
1
開始ページ
85
終了ページ
90
出版者
Spandidos Publications
出版年月日
2013-05-14
ISSN
1021-335X
NCID
AA11016405
PMID
23674165
DOI
10.3892/or.2013.2466
資料タイプ
学位論文
言語
英語
関連情報URL
https://doi.org/10.3892/or.2013.2466
権利関係
Copyright © Spandidos Publications 2013.
"This is the Publisher's Version of the following article: The efficacy and safety of prophylactic closure for a large mucosal defect after colorectal endoscopic submucosal dissection; Oncology Reports; Volume 30 Issue 1 (2013) Pages: 85-90; doi: 10.3892/or.2013.2466, which has been published in final form at https://doi.org/10.3892/or.2013.2466 . "
博士論文(全文を含む)
学位授与番号
博甲第608号
学位授与年月日
2015-03-24
学位名
博士(医学)
学位授与機関
香川大学
区分
香川大学
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