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Should routine coagulation of visible vessels be performed after endoscopic submucosal dissection

Nature Clinical Practice Gastroenterology & Hepatology volume 5, pages 544–545 (2008)Cite this article

Abstract

Endoscopic submucosal dissection (ESD) is a revolutionary procedure that allows for en bloc resection of large tumors in the gastrointestinal tract; however, complications can occur including perforation and bleeding. In this Practice Point commentary, we discuss the findings and limitations of a retrospective study conducted by Takizawa and colleagues that investigated risk factors for delayed bleeding in patients with gastric cancer who underwent ESD. The findings of their study suggest that preventative electrocoagulation of nonbleeding visible vessels after ESD might reduce the incidence of delayed bleeding. In addition, tumor location was found to influence the rate of delayed bleeding. This commentary highlights the issues to consider when interpreting these findings in clinical practice, and we consider the resonance of these results for ESD of colorectal tumors.

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References

  1. Ono H et al. (1999) A new method of EMR using insulated-tipped diathermia knife. Endosc Dig 11: 675–681

    Google Scholar 

  2. Hurlstone D et al. (2007) Achieving R0 resection in the colorectum using endoscopic submucosal dissection. Brit J Surg 94: 1536–1542

    Article  CAS  Google Scholar 

  3. Tamegai Y et al. (2007) Endoscopic submucosal dissection: a safe technique for colorectal tumors. Endoscopy 39: 418–422

    Article  CAS  Google Scholar 

  4. Oda I et al. (2005) Endoscopic submucosal dissection for early gastric cancer: technical feasibility, operation time and complications from a large consecutive series. Dig Endosc 17: 54–58

    Article  Google Scholar 

  5. Takizawa et al. (2008) Routine coagulation of visible may prevent delayed bleeding after endoscopic submucosal dissection—an analysis of risk factors. Endoscopy 40: 179–183

    Article  CAS  Google Scholar 

  6. Uedo N et al. (2007) Effect of proton pump inhibitor or an H2-receptor antagonist on prevention of bleeding from ulcer after endoscopic submucosal dissection of early gastric cancer: a prospective randomised controlled trial. Am J Gastroenterol 102: 1610–1016

    Article  CAS  Google Scholar 

  7. Lin H et al. (1990) A controlled study of therapeutic endoscopy for peptic ulcer with non-bleeding visible vessel. Gastrointest Endosc 36: 241–246

    Article  CAS  Google Scholar 

  8. Hurlstone D et al. (2008) Salvage endoscopic submucosal dissection for residual or local recurrent intraepithelial neoplasia in the colorectum: a prospective analysis. Colorectal Dis [10.1111/j.1463-1318.2008.01510.]

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Authors and Affiliations

  1. DA Elphick is Locum Consultant Gastroenterologist and DP Hurlstone is Consultant Gastroenterologist in the Gastroenterology and Liver Unit at the Royal Hallamshire Hospital, Sheffield, UK.,

    David A Elphick & David P Hurlstone

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  1. David A Elphick
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  2. David P Hurlstone
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Correspondence to David P Hurlstone.

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The authors declare no competing financial interests.

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Elphick, D., Hurlstone, D. Should routine coagulation of visible vessels be performed after endoscopic submucosal dissection. Nat Rev Gastroenterol Hepatol 5, 544–545 (2008). https://doi.org/10.1038/ncpgasthep1224

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