Tatsuma Nomura1,2, Ippei Matsuzaki3, Shinya Sugimoto4, Jun Oyamda4, Akira Kamei4, Makoto Kobayashi5. 1. Department of Gastroenterology, Kinan Hospital, 4750 Atawa, Mihama-cho, Minamimuro-Gun, Mie, 519-5293, Japan. m06076tn@icloud.com. 2. Department of Gastroenterology, Ise Red Cross Hospital, Ise, Mie, Japan. m06076tn@icloud.com. 3. Department of Gastroenterology, Yamashita Hospital, Ichinomiya, Aichi, Japan. 4. Department of Gastroenterology, Ise Red Cross Hospital, Ise, Mie, Japan. 5. Department of Gastroenterology, Yokkaichi Municipal Hospital, Yokkaichi, Mie, Japan.
Abstract
BACKGROUND: The closure of mucosal defects after colorectal endoscopic submucosal dissection (ESD) remains difficult. Therefore, various methods and devices have been developed to aid in this procedure. However, a standard method for mucosal defect closure after ESD has not been established. We aimed to examine the efficiency and safety of our clip-on-clip closure method (CCCM) after colorectal ESD. METHODS: The CCCM is a novel method for colorectal mucosal defect closure that uses a conventional clip on the handle of another clip, with the gap as an anchor. The CCCM was prospectively used for closing mucosal defects in 30 patients with 32 lesions after colorectal ESD at the Japanese Ise Red Cross Hospital, Yokkaichi Municipal Hospital, and Medical Corporation Yamashita Hospital between March 2018 and July 2018. Outcome measures were closure success rates of CCCM, procedural closure time, and postoperative adverse events. RESULTS: The median resected specimen size was 34 mm (range 28-73 mm) and the median CCCM defect closure success rate was 97% (31/32). The median procedural time was 8 min (range 3.5-29.2 min), and the median number of clips used was 12 pieces (range 5-20). None of the patients had postoperative adverse events. CONCLUSIONS: CCCM is an efficient, safe, and simple method for the closure of mucosal defects after colorectal ESD that can be performed using only conventional clips.
BACKGROUND: The closure of mucosal defects after colorectal endoscopic submucosal dissection (ESD) remains difficult. Therefore, various methods and devices have been developed to aid in this procedure. However, a standard method for mucosal defect closure after ESD has not been established. We aimed to examine the efficiency and safety of our clip-on-clip closure method (CCCM) after colorectal ESD. METHODS: The CCCM is a novel method for colorectal mucosal defect closure that uses a conventional clip on the handle of another clip, with the gap as an anchor. The CCCM was prospectively used for closing mucosal defects in 30 patients with 32 lesions after colorectal ESD at the Japanese Ise Red Cross Hospital, Yokkaichi Municipal Hospital, and Medical Corporation Yamashita Hospital between March 2018 and July 2018. Outcome measures were closure success rates of CCCM, procedural closure time, and postoperative adverse events. RESULTS: The median resected specimen size was 34 mm (range 28-73 mm) and the median CCCM defect closure success rate was 97% (31/32). The median procedural time was 8 min (range 3.5-29.2 min), and the median number of clips used was 12 pieces (range 5-20). None of the patients had postoperative adverse events. CONCLUSIONS: CCCM is an efficient, safe, and simple method for the closure of mucosal defects after colorectal ESD that can be performed using only conventional clips.
Authors: Heiko Pohl; Ian S Grimm; Matthew T Moyer; Muhammad K Hasan; Douglas Pleskow; B Joseph Elmunzer; Mouen A Khashab; Omid Sanaei; Firas H Al-Kawas; Stuart R Gordon; Abraham Mathew; John M Levenick; Harry R Aslanian; Fadi Antaki; Daniel von Renteln; Seth D Crockett; Amit Rastogi; Jeffrey A Gill; Ryan J Law; Pooja A Elias; Maria Pellise; Michael B Wallace; Todd A Mackenzie; Douglas K Rex Journal: Gastroenterology Date: 2019-03-15 Impact factor: 22.682
Authors: Sergey V Kantsevoy; Marianne Bitner; Aleksandr A Mitrakov; Paul J Thuluvath Journal: Gastrointest Endosc Date: 2013-12-12 Impact factor: 9.427