International Session(Workshop)3(JGES・JSGE・JSGS・JSGCS)
Sat. November 4th   14:00 - 16:30   Room 11: Portopia Hotel South Wing Topaz
Feasibility of traction-band-assisted endoscopic closure for a mucosal defect after colorectal endoscopic submucosal dissection: A multi-center prospective study
Mitsuru Esaki1, Yorinobu Sumida2, Eikichi Ihara1
1Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 2Department of Gastroenterology, Kitakyushu Municipal Medical Center
[Aims] Endoscopic closure for mucosal defects after colorectal endoscopic submucosal dissection (ESD) prevents delayed complications. We have developed a traction-band-assisted endoscopic closure (TBEC) method using clip with traction band (SureClip Traction Band, MICRO-TECH, Nanjing, China; Endoscopy 2022;54:E1005-1006). We conducted a prospective study further to evaluate the feasibility of TBEC in colorectal ESD.
[Methods] Patients with 20-50mm colorectal neoplasms were enrolled. Patients underwent TBEC following completion of ESD. The primary outcome was complete closure rate. The secondary outcomes included closure time and complication rate. The sample size was calculated as 34 cases based on the previous data.
[Results] Thirty-four patients were enrolled in three institutions. The data were shown as median (IQR), if applicable. The lesion locations were the right colon, left colon, and rectum in a ratio of 22:10:2, respectively. Lesion diameter was 30 mm (25-35). All ESDs achieved en-bloc resection. Complete closure rate was 100% (34/34). Closure time was 15 minutes (10-22). Procedure-related complications included intraoperative perforation in 5.8% (2/34), delayed bleeding in 2.9% (1/34), and post-ESD electrocoagulation syndrome in 3.1% (1/32, excluding intraoperative perforation).
[Conclusion] A high complete closure rate of mucosal defects after colorectal ESD was achieved by TBEC. Further study is required to verify the efficacy of TBEC in preventing delayed complications.
Index Term 1: Endoscopic closure
Index Term 2: Endoscopic submucosal dissection
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