Delayed perforation: A hazardous complication of endoscopic resection for non-ampullary duodenal neoplasm

2013 ◽  
Vol 26 (2) ◽  
pp. 220-227 ◽  
Author(s):  
Takuya Inoue ◽  
Noriya Uedo ◽  
Takeshi Yamashina ◽  
Sachiko Yamamoto ◽  
Noboru Hanaoka ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Duodenal Neoplasm ◽  
Delayed Perforation

Endoscopic Resections in Inflammatory Bowel Disease: A Multicentre European Outcomes Study

2019 ◽  
Vol 13 (11) ◽  
pp. 1394-1400
Author(s):  
A Alkandari ◽  
S Thayalasekaran ◽  
M Bhandari ◽  
A Przybysz ◽  
M Bugajski ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Endoscopic Resection ◽  
Bowel Disease ◽  
En Bloc ◽  
Increased Risk ◽  
Delayed Perforation ◽  
Inflammatory Bowel ◽  
Outcomes Study ◽  
Almost All ◽  
Current Guidelines

Abstract Background and Aims Inflammatory bowel disease is associated with an increased risk of colorectal cancer, with estimates ranging 2–18%, depending on the duration of colitis. The management of neoplasia in colitis remains controversial. Current guidelines recommend endoscopic resection if the lesion is clearly visible with distinct margins. Colectomy is recommended if complete endoscopic resection is not guaranteed. We aimed to assess the outcomes of all neoplastic endoscopic resections in inflammatory bowel disease. Methods This was a multicentre retrospective cohort study of 119 lesions of visible dysplasia in 93 patients, resected endoscopically in inflammatory bowel disease. Results A total of 6/65 [9.2%] lesions <20 mm in size were treated by ESD [endoscopic submucosal dissection] compared with 59/65 [90.8%] lesions <20 mm treated by EMR [endoscopic mucosal resection]; 16/51 [31.4%] lesions >20 mm in size were treated by EMR vs 35/51 [68.6%] by ESD. Almost all patients [97%] without fibrosis were treated by EMR, and patients with fibrosis were treated by ESD [87%], p < 0.001. In all, 49/78 [63%] lesions treated by EMR were resected en-bloc and 27/41 [65.9%] of the ESD/KAR [knife-assisted resection] cases were resected en-bloc, compared with 15/41 [36.6%] resected piecemeal. Seven recurrences occurred in the cohort. Seven complications occurred in the cohort; six were managed endoscopically and one patient with a delayed perforation underwent surgery. Conclusions Larger lesions with fibrosis are best treated by ESD, whereas smaller lesions without fibrosis are best managed by EMR. Both EMR and ESD are feasible in the management of endoscopic resections in colitis.

Endoscopic tissue shielding with polyglycolic acid sheets, fibrin glue and clips to prevent delayed perforation after duodenal endoscopic resection

2014 ◽  
Vol 26 ◽  
pp. 41-45 ◽  
Author(s):  
Hisashi Doyama ◽  
Kei Tominaga ◽  
Naohiro Yoshida ◽  
Kenichi Takemura ◽  
Shinya Yamada
Keyword(s):  
Fibrin Glue ◽  
Endoscopic Resection ◽  
Polyglycolic Acid ◽  
Delayed Perforation

scholarly journals Endoscopic Resection for Gastric Subepithelial Tumor with Backup Laparoscopic Surgery: Description of a Single-Center Experience

2021 ◽  
Vol 10 (19) ◽  
pp. 4423
Author(s):  
Wei-Jung Chang ◽  
Lien-Cheng Tsao ◽  
Hsu-Heng Yen ◽  
Chia-Wei Yang ◽  
Joseph Lin ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Endoscopic Resection ◽  
Muscularis Propria ◽  
Single Center Experience ◽  
Lengths Of Stay ◽  
Gastric Stenosis ◽  
Delayed Perforation ◽  
Gastric Subepithelial Tumors ◽  
Upper Third

The aim of this study was to analyze patients who underwent endoscopic resection (ER) for gastric subepithelial tumors (SETs) with a high probability of surgical intervention. Between January 2013 and January 2021, 83 patients underwent ER at the operation theater and 27 patients (32.5%) required backup surgery mainly due to incidental perforation or uncontrolled bleeding despite endoscopic repairing. The tumor was predominantly located in the upper-third stomach (81%) with a size ≤ 2 cm (69.9%) and deep to the muscularis propria (MP) layer (92.8%) but there were no significant differences between two groups except tumor exophytic growth as a risk factor in the surgery group (37% vs. 0%, p < 0.0001). Patients in the ER-only group had shorter durations of procedure times (60 min vs. 185 min, p < 0.0001) and lengths of stay (5 days vs. 7 days, p < 0.0001) but with a higher percentage of overall morbidity graded III (0% vs. 7.1%, p = 0.1571). After ER, five patients (6%) had delayed perforation and two (2.4%) required emergent laparoscopic surgery. Neither recurrence nor gastric stenosis was reported during long-term surveillance. Here, we provide a minimally invasive strategy of endoscopic resection with backup laparoscopic surgery for gastric SETs.

scholarly journals A CASE OF DELAYED PERFORATION OF THE STOMACH AFTER ENDOSCOPIC RESECTION OF SUBMUCOSAL TUMOR

1999 ◽  
Vol 60 (9) ◽  
pp. 2353-2356
Author(s):  
Hidejiro KAWAHARA ◽  
Makoto OHNO ◽  
Hirotoshi ISHIKAWA ◽  
Seigo IGARASHI ◽  
Katsuya HIRAI ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Submucosal Tumor ◽  
Delayed Perforation

scholarly journals Delayed perforation after endoscopic resection of a colonic laterally spreading tumor: A case report and literature review

2020 ◽  
Vol 8 (16) ◽  
pp. 3608-3615
Author(s):  
Ge-Yu-Jia Zhou ◽  
Jin-Long Hu ◽  
Sheng Wang ◽  
Nan Ge ◽  
Xiang Liu ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Endoscopic Resection ◽  
Laterally Spreading Tumor ◽  
Delayed Perforation

Safety and feasibility of laparoscopic and endoscopic cooperative surgery for duodenal neoplasm: A retrospective multicenter study

Endoscopy ◽  
2020 ◽  
Author(s):  
Souya Nunobe ◽  
Motonari Ri ◽  
Kimiyasu Yamazaki ◽  
Masanao Uraoka ◽  
Ken Ohata ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Clinical Characteristics ◽  
Duodenal Neoplasms ◽  
En Bloc ◽  
Duodenal Neoplasm ◽  
Delayed Perforation ◽  
Surgical Duration ◽  
Technical Safety ◽  
Retrospective Multicenter Study

Background and study aims A delayed perforation can often occur after endoscopic treatment for duodenal neoplasms and cause fatality due to leakage of pancreatic and bile juices. We aimed to evaluate the feasibility and safety of laparoscopic and endoscopic cooperative surgery for duodenal neoplasms (D-LECS) in a multicenter retrospective study. Patients and methods The clinical characteristics and surgical outcomes of 206 patients with duodenal neoplasms in whom D-LECS had initially been attempted at one of 14 institutions were retrospectively reviewed. Results Of the 206 patients, 63 (31%), 128 (62%), and 15 patients (7%) had lesions at the bulb, second portion, and third portion of the duodenum, respectively. The rates of en bloc and R0 resections during D-LECS were 96% and 95%, respectively. Intraoperative and delayed perforations occurred in 9 (4.3%) and 5 patients (2.4%), respectively. No recurrent cases were observed in this study. The risks of postoperative complications were surgical duration of ≥3 h. Conclusions The results of the present study revealed that D-LECS was performed with oncological feasibility with technical safety.

scholarly journals Delayed perforation caused by an endoscopic clip following uncomplicated endoscopic resection of a large sporadic nonampullary duodenal adenoma

Endoscopy ◽  
2016 ◽  
Vol 48 (S 01) ◽  
pp. E211-E212 ◽  
Author(s):  
Moritz von Wulffen ◽  
Alexander Huelsen ◽  
Tom O’Rourke ◽  
Nivene Saad ◽  
Saurabh Gupta
Keyword(s):  
Endoscopic Resection ◽  
Duodenal Adenoma ◽  
Endoscopic Clip ◽  
Delayed Perforation

scholarly journals Clinical outcomes of endoscopic resection for superficial non-ampullary duodenal tumors

2020 ◽  
Vol 08 (03) ◽  
pp. E354-E359
Author(s):  
Kazutaka Kuroki ◽  
Yoji Sanomura ◽  
Shiro Oka ◽  
Naoki Yorita ◽  
Mio Kurihara ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
University Hospital ◽  
Clinical Validity ◽  
En Bloc ◽  
Endoscopic Closure ◽  
Delayed Perforation ◽  
Study Participants

Abstract Background and study aims Because superficial non-ampullary duodenal epithelial tumors (SNADETs) are relatively rare, studies evaluating the outcomes of endoscopic resection (ER) for SNADETs are limited. Therefore, this study aimed to evaluate the clinical validity of ER for SNADETs. Patients and methods The study participants included 163 consecutive patients (108 men; mean age, 61.5 ± 11.3 years) with 171 SNADETs, excluding patients with familial adenomatous polyposis resected by ER, at Hiroshima University Hospital between May 2005 and September 2016. Clinicopathological features and the outcomes of ER for 171 cases were retrospectively analyzed. Additionally, the prognosis of 135 patients with more than 12 months’ follow-up was analyzed. Results Mean diameter of SNADETs was 10.7 ± 7.2 mm. Most of the SNADET cases were classified as category 3 (71 %, 121/171), but some were category 5 (2 %, 3/171). En bloc resection rates were 93 % (146/157), 100 % (7/7), and 86 % (6/7) in endoscopic mucosal resection (EMR), polypectomy, and in endoscopic submucosal dissection (ESD) cases, respectively. Complete resection rates were 90 % (141/157), 100 % (7/7), and 71 % (5/7) in EMR, polypectomy, and ESD cases, respectively. Emergency surgery was performed in two patients with intraoperative perforation and in two with delayed perforation without artificial ulcer bed closure after ER. Since endoscopic closure of ulcer by clipping was performed, delayed perforation has not occurred. Local recurrence occurred in 1.2 %, but no metastasis to lymph nodes or other organs occurred after ER. No patient died of primary SNADETs. Conclusion Our data supported the clinical validity of ER for SNADETs. However, delayed perforation should be given much attention.

Endoscopic Resection of the Olecranon and Pre-Patellar Bursa

Swiss Surgery ◽  
2001 ◽  
Vol 7 (3) ◽  
pp. 121-125 ◽  
Author(s):  
Nussbaumer ◽  
Candrian ◽  
Hollinger
Keyword(s):  
Endoscopic Resection ◽  
Postoperative Komplikationen

Fragestellung: Gemäss Literatur treten nach chirurgischer Behandlung entzündlich veränderter Bursae präpatellar oder am Olecranon in rund 20% der Fälle Narbenbeschwerden auf. Die Frage ist, ob durch ein endoskopisches Vorgehen, welches erstmals 1990 beschrieben wurde, die Häufigkeit dieser Komplikationen reduziert werden kann. Methode: Im Rahmen einer prospektiven Studie wurde bei 13 Patienten mit einer Bursitis ein endoskopisches Bursa-shaving durchgeführt. Alle Patienten wurden drei Wochen und sechs Monate postoperativ klinisch nachkontrolliert. Resultate: Bei neun Patienten wurde eine Bursa olecrani entfernt, viermal eine Bursa präpatellaris. In 11 Fällen handelte es sich um eine akute, infizierte Bursitis. Die Eingriffe wurden je zur Hälfte in Vollnarkose bzw. Regionalanästhesie durchgeführt. Intra- sowie postoperative Komplikationen wurden keine beobachtet. Bei den Nachkontrollen waren sämtliche Patienten beschwerdefrei und zeigten eine volle Funktion des betroffenen Gelenks. Schlussfolgerung: In unseren Händen hat sich das endoskopische Bursashaving zur chirurgischen Therapie der Bursitis bewährt. Im Vergleich zur konventionellen Bursektomie können insbesondere Wundheilungsstörungen und chronische Narbenbeschwerden reduziert werden.

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