Endoscopy 2021; 53(S 01): S177
DOI: 10.1055/s-0041-1724737
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Prophylactic Endoscopic Closure After Widespread ESD/EMR (Colon Polyps ≥20MM) in the Colorectum Using the Over-the-Scope-Clip (OTSC) System. A Retrospective Study

T Blasberg
1   Sana Klinikum Offenbach, Gastroenterology, Gastrointestinal Oncology and Interventional Endoscopy, Offenbach, Germany
,
L Leifeld
2   St. Bernwards Krankenhaus, Gastroenterology and Internal Medicine, Hildesheim, Germany
,
C Jung
3   Forlì-Cesena Hospitals, AUSL Romagna, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena, Italy
,
J Hochberger
4   VIVANTES-Gesundheitsnetzwerk - Klinikum Friedrichshain, Gastroenterology, Gastrointestinal Oncology and Interventional Endoscopy, Berlin, Germany
,
E Wedi
1   Sana Klinikum Offenbach, Gastroenterology, Gastrointestinal Oncology and Interventional Endoscopy, Offenbach, Germany
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    Aims This study aims to evaluate the efficacy and safety of prophylactic tissue approximation and wound reduction using the OTSC-System after complex endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) of large (≥20mm) colonic and rectal superficial lesions.

    Methods Between February 2009 and March 2016 a total of 59 patients with large (≥20mm) colonic and rectal superficial lesions were enrolled in this study. All lesions were either removed by ESD or EMR. The post-ESD or post-EMR mucosal defect was closed using the OTSC-System. For this interventional 2-center study, data were collected prospectively and analysis was performed retrospectively.

    Results In total 59 patients (mean age 64.5 ± 10.7 years; female 32 % (19/59); male 40 % (40/59)), underwent ESD (64.4 %, 38/59) or EMR (35.6 %, 21/59) in the colorectum. The mean lesion diameter was 63mm ± 29.5 (range 22-130mm). Complete R0 resection rate of ESD and EMR was 86.8 % and 85.7 %, respectively. The mean number of OTSC clips placed on the mucosal defect was two (range 1 – 5). In 6 patients (10.2 %, 6/59) OTSC clips were used due to intraoperative minor adverse events as intraoperative bleeding occurred in 6.8 % (ESD 2.6 % vs. EMR 14.3 %) and intraoperative perforation in 3.4 % (ESD 2.6 % vs. EMR 4.8 %) of the cases. Among the remaining 53 patients (89.9 %, 53/59) who received prophylactic clipping, delayed postoperative bleeding (DPPB) occurred in 1.9 % (ESD 0 % vs. EMR 5.9 %) and delayed perforation in 0 % of the cases.

    Conclusions Prophylactic tissue approximation and wound reduction of large post-ESD/EMR defects using the OTSC-system may be an effective strategy in reducing the risk of DPPB and delayed perforation.

    Citation:Blasberg T, Leifeld L, Jung C et al. eP241 PROPHYLACTIC ENDOSCOPIC CLOSURE AFTER WIDESPREAD ESD/EMR (COLON POLYPS ≥20MM) IN THE COLORECTUM USING THE OVER-THE-SCOPE-CLIP (OTSC) SYSTEM. A RETROSPECTIVE STUDY. Endoscopy 2021; 53: S177.


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    Publication History

    Article published online:
    19 March 2021

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