Hamada Shohei, Ihara Eikichi, Yoshitake Chikako, Inada Taisuke, Fukuya Hiroki, Ohkubo Akito, Tomoeda Naru, Iboshi Yoichiro, Sumida Yorinobu, Yoshimura Daisuke, Nakamuta Makoto, Harada Naohiko
Department of Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Dig Endosc. 2023 Jan;35(1):136-139. doi: 10.1111/den.14417. Epub 2022 Aug 29.
Endoscopic submucosal dissection (ESD) is globally performed to treat early epithelial tumors of the gastrointestinal tract, but delayed perforation is a problematic procedure-related complication. To address this problem, closure of ESD-induced mucosal defects with a detachable snare has been reported. However, one problem is that this method usually requires some degree of skill and replacing a single-channel scope with a two-channel scope. We developed the clip stopper closure (CSC) method using a detachable snare in combination with the ZEOCLIP, which can be easily performed with a single-channel scope, for ESD-induced mucosal defects. Six consecutive cases were treated with this closure method for colonic ESD-induced mucosal defects. The median closure time was 12.5 (10-24) min, and the success rate of this procedure was 100%. Our CSC method was able to be performed in any part of the colon. In conclusion, the CSC method using a detachable snare in combination with the ZEOCLIP is a simple but promising closure technique for ESD-induced mucosal defects.
内镜黏膜下剥离术（ESD）在全球范围内用于治疗胃肠道早期上皮肿瘤，但延迟穿孔是一种与手术相关的棘手并发症。为了解决这个问题，已有报道使用可分离圈套器封闭ESD引起的黏膜缺损。然而，一个问题是这种方法通常需要一定程度的技巧，并且需要将单通道内镜换成双通道内镜。我们开发了一种使用可分离圈套器结合ZEOCLIP的夹子封堵术（CSC）方法，用于ESD引起的黏膜缺损，该方法使用单通道内镜即可轻松完成。连续6例结肠ESD引起的黏膜缺损患者接受了这种封闭方法治疗。中位封闭时间为12.5（10 - 24）分钟，该手术成功率为100%。我们的CSC方法可在结肠的任何部位进行。总之，使用可分离圈套器结合ZEOCLIP的CSC方法是一种简单但有前景的ESD引起的黏膜缺损封闭技术。
