The Efficacy and Safety of a Promising Single-Channel Endoscopic Closure Technique for Endoscopic Treatment-Related Artificial Ulcers: A Pilot Study

Abstract

<b><i>Background/Aims:</i></b> It is important to appropriately manage patients with procedure-related artificial mucosal ulcers or procedure-related complications. Many endoscopic closure techniques have been reported; however, they often require the use of special devices. We developed a single-channel endoscopic closure technique (SCCT) that can be performed with conventional devices. In the present study, we describe the technique and evaluate its efficacy. <b><i>Methods:</i></b> Twenty-five consecutive patients who underwent endoscopic treatment and whose artificial ulcer was closed using the SCCT were enrolled in this study. The technical success rate, number of clips for closure, procedure time, complication rate on the day of the procedure, clinical success rates on days 1 and 5, and incidence of severe stenosis of the gastrointestinal (GI) tract at 2 months after the procedure were evaluated. <b><i>Results:</i></b> The median ulcer diameter was 20 mm. The tumor locations were the stomach (<i>n</i> = 19), jejunum (<i>n</i> = 1), and colon (<i>n</i> = 5). The technical success rate was 100% (25/25), and the rate of incomplete closure was 0% (0/25). Eight clips were needed on average. The median procedure time was 18 min (range 5–49 min). The complication rate was 0% (25/25). The clinical success rates on days 1 and 5 were 100% (19/19) and 100% (9/9), respectively. No patients presented stenosis as a late complication at 2 months after the procedure (0/25). <b><i>Conclusion:</i></b> The SCCT could be applied in the treatment of artificial ulcers in several parts of the GI tract with a high clinical success rate and no complications. The SCCT appears to be a good option for closing artificial mucosal ulcers.

Clip stopper closure method using a detachable snare in combination with ZEOCLIP for endoscopic submucosal dissection‐induced mucosal defects

“…D ELAYED PERFORATION IS a problematic ESDrelated complication, especially when the muscle layer is coagulated extensively during the ESD procedure. 1,5 Delayed perforation is often the most severe complication and requires surgery, and is the most unavoidable complication. Therefore, it is effective to close ESD-induced mucosal defects to prevent this complication.…”

“…Various methods for closing ESD-induced mucosal defects have been reported. [5][6][7][8][9][10][11][12][13] The essential part of the CSC method is that the detachable snare should be able to be easily tightened using a clip as a stopper with a commonly available device. While we previously reported a closure technique using a single-channel scope for ESD-induced mucosal defects, 5 some skill is required to complete this procedure.…”

“…Delayed perforation is a problematic ESD‐related complication, especially when the muscle layer is coagulated extensively during the ESD procedure 1,5 . Delayed perforation is often the most severe complication and requires surgery, and is the most unavoidable complication.…”

Efficacy of ultrasound endoscopy with artificial intelligence for the differential diagnosis of non-gastric gastrointestinal stromal tumors

“…It is widely accepted that GISTs should be treated because of their malignant potential 4 – 6 . Although endoscopic ultrasound (EUS) has been reported as the most suitable modality for the diagnosis of SELs, it remains technically impossible to distinguish GISTs from non-GISTs using EUS alone 5 , 7 ; thus, sampling of lesion tissue is required, such as via EUS-guided fine-needle aspiration/biopsy (EUS-FNAB) 4 – 6 , 8 – 11 .…”

Complete closure of mucosal defect after colonic endoscopic submucosal dissection using clip with a silicone traction band

“…Therefore, complete closure of defects after ESD is essential to prevent such complications [3]. Although complete closure is a technically difficult procedure, several techniques have been developed to assist [4,5]. Herein, we present a case of successful complete closure of a mucosal defect after colonic ESD using clips with a silicone traction band (▶ Fig.…”