Gastric fundal perforation: a rare but severe adverse event associated with endoscopic submucosal dissection for esophageal mucosal lesions

Complications after endoscopic submucosal dissection for early colorectal cancer (Review)

“…Most bleeding from small vessels after ESD can be stopped by electrocoagulation ( 14 ). Bleeding from larger vessels requires hemostasis by metal clip closure combined with electrocoagulation ( 14 ). During ESD, effective identification of submucosal vessels, timely electrocoagulation and careful treatment of trauma are essential.…”

“…For larger perforations, metal clips combined with nylon rope wrap, alongside fasting and gastrointestinal decompression, the use of intravenous antibiotics and other means, may be required; generally, the treatment is effective ( 78 ). Surgical laparoscopic exploration and repair are preferable in cases of delayed perforation that cannot be completely closed endoscopically or for cases in which conservative treatment is ineffective ( 14 ) ( Fig. 3 ).…”

“…Measures to prevent and treat bleeding. Most bleeding from small vessels after ESD can be stopped by electrocoagulation (14). Bleeding from larger vessels requires hemostasis by metal clip closure combined with electrocoagulation (14).…”

“…Surgery was once considered the standard method for treating early-stage gastrointestinal cancer; however, although surgery can completely remove a lesion, it has a number of disadvantages, including the associated trauma, slow recovery and high complication rates. Compared with traditional surgery, ESD preserves normal bowel function, and results in less trauma and faster postoperative recovery ( 14 ). Moreover, patients who undergo ESD for the treatment of ECC and precancerous lesions have a higher overall survival rate, with a long-term prognosis similar to that of conventional surgery ( 15 ).…”