International Session(Workshop)3(JGES・JSGE・JSGS・JSGCS)
Sat. November 4th   14:00 - 16:30   Room 11: Portopia Hotel South Wing Topaz
Loop9 closure technique for mucosal defects after colorectal endoscopic submucosal dissection
Marc Navarro1, Mayo Tanabe1, Haruhiro Inoue1
1Digestive Diseases Center, Showa University Koto Toyosu Hospital
Objectives: Mucosal defect closure after colorectal endoscopic submucosal dissection (ESD) may decrease the incidence of delayed adverse events (AEs). This study aimed to assess the efficacy of the novel loop9 method for complete defect closure after colorectal ESD.
Methods: This study included 109 lesions in 106 patients who underwent colorectal ESD. Handmade Loop9 was delivered through a single instrument channel (3.2 mm) and released at the defect site. After being anchored by two clips positioned at opposite sides of the defect, loop9 was tightened by pulling the end of the suture intraluminally using biopsy forceps for approximation. Additional conventional clips were placed to achieve complete closure. The primary outcome was the loop9 closure success rate. Secondary outcomes were the sustained closure rate, procedure time, number of additional clips, and the incidence of delayed AEs.
Results: Complete closure was achieved in 96.3%(105/109) cases. The median size of the mucosal defects was 3.0cm (range:2.0-10.4). The sustained closure rate was 96.1%(101/105). The median closure time was 15 minutes (IQR:12-17). The median number of additional clips was 5 (IQR:4-6). Stenosis requiring balloon dilatation was observed in one patient, while no post-ESD bleeding and delayed perforation were noted.
Conclusion: The loop9 method was effective and facilitated complete mucosal defect closure after colorectal ESD, showing high success and sustained closure rate.
Index Term 1: Defect Closure
Index Term 2: Loop9
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