Clinical outcomes for perforations during endoscopic submucosal dissection in patients with gastric lesions

Title
Clinical outcomes for perforations during endoscopic submucosal dissection in patients with gastric lesions
Author(s)
장병익전성우[전성우]정민규[정민규]김성국[김성국]조광범[조광범]박경식[박경식]박창근[박창근]권중구[권중구]정진태[정진태]김은영[김은영]김태년양창헌[양창헌]
Keywords
CIRCUMFERENTIAL MUCOSAL INCISION; NONSURGICAL MANAGEMENT; RISK-FACTORS; RESECTION; CANCER; EMR
Issue Date
201004
Publisher
SPRINGER
Citation
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, v.24, no.4, pp.911 - 916
Abstract
The endoscopic submucosal dissection (ESD) technique has been gaining popularity, with continued advances in this treatment approach. However, ESD still is associated with potential complications such as severe bleeding and perforation. This study was performed to compare the clinical outcomes for macro- and microperforations with ESD procedures and to determine the short-term prognosis after ESD. A macroperforation was defined as a gross perforation that occurred during an ESD procedure, and a microperforation was defined by free air observed on simple radiography after the procedure. Immediate closure of macroperforations was performed using endoclips. From July 2003 through May 2008, 1,711 patients underwent ESD for gastric lesions such as dysplasia, early cancer, and subepithelial lesions. Among 39 perforation cases (2.3%), macroperforations occurred for 26 patients (67%) and microperforations for 13 patients (33%). All the patients except one who underwent emergency surgery because of severe bleeding and perforation during ESD were managed successfully by intravenous antibiotics and no oral intake. The clinical prognosis and endoscopic characteristics of the patients with macroperforations did not differ from those of the patients with microperforations. Perforations associated with ESD could be managed safely and successfully by nonsurgical methods. The clinical prognoses for macro- and microperforations were favorable and comparable.
URI
http://hdl.handle.net/YU.REPOSITORY/22621http://dx.doi.org/10.1007/s00464-009-0693-y
ISSN
0930-2794
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의과대학 > 내과학교실 > Articles
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