scholarly journals Mucosal defect closure after duodenal endoscopic submucosal dissection using the reopenable‐clip over the line method

JGH Open ◽  
2021 ◽  
Author(s):  
Tatsuma Nomura ◽  
Shinya Sugimoto ◽  
Nobuyuki Tsuda ◽  
Ryutaro Matsushima ◽  
Jun Oyamada ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Defect Closure ◽  
Line Method ◽  
Submucosal Dissection ◽  
Mucosal Defect

scholarly journals Thread-assisted mucosal defect closure using the locking-clip technique after gastric endoscopic submucosal dissection

Endoscopy ◽  
2018 ◽  
Vol 50 (12) ◽  
pp. E342-E343 ◽  
Author(s):  
Tatsuma Nomura ◽  
Akira Kamei ◽  
Shinya Sugimoto ◽  
Tetsuro Harada ◽  
Jun Oyamda
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Defect Closure ◽  
Submucosal Dissection ◽  
Mucosal Defect

877 MUCOSAL DEFECT CLOSURE BY ENDOSCOPIC HAND-SUTURING MAY REDUCE BLEEDING RISK AFTER GASTRIC ENDOSCOPIC SUBMUCOSAL DISSECTION: A MULTICENTER PILOT STUDY

2020 ◽  
Vol 91 (6) ◽  
pp. AB71-AB72
Author(s):  
Osamu Goto ◽  
Tsuneo Oyama ◽  
Hiroyuki Ono ◽  
Akiko Takahashi ◽  
Mitsuhiro Fujishiro ◽  
...  
Keyword(s):  
Pilot Study ◽  
Endoscopic Submucosal Dissection ◽  
Bleeding Risk ◽  
Defect Closure ◽  
Submucosal Dissection ◽  
Mucosal Defect

Efficacy of an over-the-scope clip for preventing adverse events after duodenal endoscopic submucosal dissection: a prospective interventional study

Endoscopy ◽  
2018 ◽  
Vol 50 (05) ◽  
pp. 487-496 ◽  
Author(s):  
Tomoaki Tashima ◽  
Ken Ohata ◽  
Eiji Sakai ◽  
Yoshitsugu Misumi ◽  
Maiko Takita ◽  
...  
Keyword(s):  
Adverse Events ◽  
Endoscopic Submucosal Dissection ◽  
R0 Resection ◽  
Defect Closure ◽  
Submucosal Dissection ◽  
Mucosal Defect ◽  
Over The Scope Clip ◽  
Delayed Perforation ◽  
The Mean ◽  
Severe Adverse Events

Abstract Background Duodenal endoscopic submucosal dissection (ESD) remains technically challenging, with a high risk of severe adverse events. Because exposure of the duodenal post-ESD mucosal defect to pancreatic juice and bile acid reportedly induces delayed perforation and bleeding, we examined whether defect closure using an over-the-scope clip (OTSC) system was useful for preventing postoperative adverse events. Methods From April 2016 to February 2017, a total of 50 consecutive patients with superficial non-ampullary duodenal epithelial tumors (SNADETs) larger than 10 mm, with no more than semi-circumferential spread, were prospectively enrolled in this study. All of the lesions were treated by experienced ESD operators and the post-ESD mucosal defect was closed using OTSCs. Results All of the SNADETs were completely removed by ESD, with an R0 resection rate of 88.0 %. The mean procedure and closure times were 67.3 ± 58.8 minutes and 9.8 ± 7.2 minutes, respectively. Although complete defect closure was achieved in 94.0 % of the patients (47/50), two patients required surgical conversion. Delayed perforation occurred in only one patient (2.1 %), who did not have successful closure of the defect, as misplacement of the OTSC exposed the muscle layer. Meanwhile, delayed bleeding occurred in three patients (6.3 %); however, the bleeding was easily controlled using endoscopic coagulation. The mean duration of postoperative hospitalization was 5.5 ± 7.2 days. Conclusions Prophylactic defect closure using OTSCs may be effective in reducing severe adverse events after duodenal ESD.

A novel endoscopic hand-suturing technique for defect closure after colorectal endoscopic submucosal dissection: a pilot study

Endoscopy ◽  
2020 ◽  
Vol 52 (09) ◽  
pp. 780-785
Author(s):  
Seiichiro Abe ◽  
Yutaka Saito ◽  
Yusaku Tanaka ◽  
Mai Ego ◽  
Fumito Yanagisawa ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Ex Vivo ◽  
Barbed Suture ◽  
Procedure Time ◽  
Closure Rate ◽  
Needle Holder ◽  
Lower Rectum ◽  
Submucosal Dissection ◽  
Mucosal Defect ◽  
Colorectal Endoscopic Submucosal Dissection

Abstract Background This study aimed to demonstrate the feasibility of endoscopic hand-suturing (EHS) and attainability of sustained closure after colorectal endoscopic submucosal dissection (ESD). Methods EHS was defined as uninterrupted endoscopic suturing of the mucosal defect after colorectal ESD using an absorbable barbed suture and a through-the-scope needle holder. Following individual EHS training using an ex vivo porcine colonic model, two experienced endoscopists performed EHS. Repeat colonoscopy was performed on the third or fourth day after ESD to examine the EHS site. The primary end point was the complete EHS closure rate, and secondary end points were sustained closure and post-ESD bleeding rates. Results 11 lesions were included. Median size of the mucosal defect was 38 mm (range 25 – 55 mm) and the lesion characteristics were as follows: lower rectum/upper rectum/ascending colon/cecum = 3/3/2/3, and 0-IIa/0-Is + IIa/others = 5/4/2. EHS was not attempted in two patients owing to difficulty in colonoscope reinsertion after ESD and intraoperative perforation, respectively. EHS was performed for nine lesions, and the complete EHS closure rate was 73 %. Median procedure time for suturing was 56 minutes (range 30 – 120 minutes) and median number of stitches was 8 (range 6 – 12). Sustained closure and post-ESD bleeding rates were 64 % and 9 %, respectively. Conclusions EHS achieved complete and sustained closure in the colorectum. However, EHS is not currently clinically applicable given the long procedure time. Further modifications of the technique and devices are desirable.

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