Korean J Gastrointest Endosc.  2008 Aug;37(2):97-104.

Nonsurgical Treatment of Gastric Perforation Complicated by Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection

Affiliations
  • 1Department of Internal Medicine, Keimyung University College of Medicine, Daegu, Korea. chokb@dsmc.or.kr
  • 2Department of Anesthesiology and Pain Medicine, Dongguk University College of Medicine, Gyeongju, Korea.

Abstract

BACKGROUND/AIMS: Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD) are novel techniques used for the treatment of early gastric cancer and precancerous lesions of the stomach. However, complications such as bleeding and perforation may occur during the procedure, and these complications may raise the morbidity and mortality rates. EMR/ESD-induced perforations can be treated with conservative medical or non-surgical methods. Furthermore, an increasing number of reports have addressed conservative management of EMR/ESD-induced perforations. We evaluated the effectiveness and safety of implementing conservative treatment for perforations associated with EMR and ESD.
METHODS
We reviewed 482 patients with 507 lesions who underwent EMR or ESD due to early gastric cancers or gastric adenomas between February 2003 and December 2007. We identified 14 perforations occurring as complications of EMR/ESD and investigated their clinical outcomes.
RESULTS
Fourteen perforations (14/507 [2.8%]) occurred, 11 of which were immediately clipped during the procedure, and 3 of which were diagnosed after the procedure when free air was visualized on the radiograph. All patients were managed conservatively with fluid resuscitation and antibiotics (mean, 5.8 days). They recovered without surgery and were discharged in stable condition at a mean of 7.2 days post-procedure.
CONCLUSIONS
Endoscopic clip application might be an effective and safe option for conservative management of EMR/ESD-induced perforations.

Keyword

Perforation; Conservative management; Endoscopic submucosal dissection
Full Text Links
  • KJGE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2020 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr