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

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URI http://shark.lib.kagawa-u.ac.jp/kuir/metadata/27647
Title
The efficacy and safety of prophylactic closure for a large mucosal defect after colorectal endoscopic submucosal dissection
File
Description

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)

Author
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
Publication Title
Oncology Reports
Publication Title Alternative
Oncol Rep.
Volume
30
Issue
1
Start Page
85
End Page
90
Publisher
Spandidos Publications
Published Date
2013-05-14
ISSN
1021-335X
NCID
AA11016405
PMID
23674165
DOI
10.3892/or.2013.2466
Resource Type
Thesis or Dissertation
Language
eng
Resource URL
https://doi.org/10.3892/or.2013.2466
Rights
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 . "
Text Version
ETD
Grant ID
博甲第608号
Grant Date
2015-03-24
Degree Name
博士(医学)
Grantor
香川大学
Set
香川大学
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