Closure of large mucosal defect by clips after colorectal endoscopic submucosal dissection: is it necessary?:A Propensity Score Matching Analysis

Background and Objectives: Large mucosal defect closure after colorectal endoscopic submucosal dissection (ESD) remains a challenging procedure for endoscopists. Various closure methods for large post-ESD mucosal defects have been proposed. However, prophylactic defect closure may not always be harmless. The aim of this study was to explore the feasibility and safety of non-closure of large mucosal defects without muscular layer injury.
Methods: A total of 173 patients with 173 lesions were included in the analysis. Parameters such as resection time, R0 resection rate, curative resection rate, and incidence of complications were compared between the closure group and non-closure group. Propensity-score matching was applied to reduce bias.
Results: After PSM, each group had 23 patients. Two patients in non-closure group experienced complication (delayed bleeding). Closure with clips did not reduced the complication rate significantly (P>0.05).
Conclusion: Non-closure of large mucosal defect without muscular layer injury after ESD is feasible and safe, which would reduce cost.