Sakurai Toshiharu, Adachi Teppei, Kono Masashi, Arizumi Tadaaki, Kamata Ken, Minaga Kosuke, Yamao Kentaro, Komeda Yoriaki, Takenaka Mamoru, Hagiwara Satoru, Watanabe Tomohiro, Nishida Naoshi, Kashida Hiroshi, Kudo Masatoshi
Department of Gastroenterology and Hepatology, Kindai University, Osaka-Sayama, Japan.
Oncology. 2017;93 Suppl 1:27-29. doi: 10.1159/000481226. Epub 2017 Dec 20.
The prophylactic closure of mucosal defects after endoscopic resection is known to prevent postoperative bleeding in colorectal lesions. However, closure of large mucosal defects is difficult with conventional clips only, and several closure techniques have been previously described; use of an Endoloop, 8-ring loop, or loop clip and a small incision around the mucosal defect. Given that the prophylactic closure requires much cost and time, the application should be limited to high-risk cases. Medication of antithrombotics or antiplatelet agents would be one of the reasonable indications for prophylactic closure of mucosal defects after endoscopic resection of colorectal tumors.
内镜切除术后预防性封闭黏膜缺损可预防结直肠病变术后出血。然而,仅用传统夹子封闭大的黏膜缺损很困难,此前已描述了几种封闭技术,如使用Endoloop、8环套圈或套圈夹以及在黏膜缺损周围做小切口。鉴于预防性封闭需要大量成本和时间,其应用应限于高危病例。抗血栓药或抗血小板药的使用可能是结直肠肿瘤内镜切除术后预防性封闭黏膜缺损的合理指征之一。