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SUCCESSFUL ENDOSCOPIC CLOSURES OF COLONIC PERFORATIONS REQUIRING ABDOMINAL DECOMPRESSION AFTER ENDOSCOPIC MUCOSAL RESECTION AND ENDOSCOPIC SUBMUCOSAL DISSECTION FOR EARLY COLON CANCER
Author(s) -
Saito Yutaka,
Matsuda Takahisa,
Kikuchi Tsuyoshi,
Ikehara Hisatomo,
Uraoka Toshio
Publication year - 2007
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2007.00729.x
Subject(s) - medicine , perforation , endoscopic mucosal resection , surgery , decompression , clipping (morphology) , endoscopic submucosal dissection , ascending colon , pneumoperitoneum , peritonitis , colon resection , lumen (anatomy) , colorectal cancer , sigmoid colon , endoscopy , colectomy , cancer , laparoscopy , rectum , materials science , punching , metallurgy , linguistics , philosophy
Endoscopic submucosal dissection (ESD) for colorectal cancer is not widely accepted because of its technical difficulty and the risk of perforation. In addition, the risk of peritonitis cannot be completely eliminated even if a perforation is closed successfully. Reported here are two cases of early colon cancer in which the patients sustained iatrogenic perforations of the ascending colon during conventional endoscopic mucosal resection and of the sigmoid colon during ESD, respectively, requiring abdominal decompression with an 18 G Medicut needle. Both of these perforations were successfully treated by endoscopic clipping. In conclusion, conservative medical management may be possible in patients who have undergone successful closure of colonic perforations using endoscopic clipping. In order to perform immediate endoscopic closure, abdominal decompression has been useful to decrease patient discomfort and colonic lumen collapse. Now, CO 2 insufflation is being used effectively for the prevention of pneumoperitoneum.