Open Access
CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(01): E11-E16
DOI: 10.1055/s-0042-121002
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Technical feasibility of line-assisted complete closure technique for large mucosal defects after colorectal endoscopic submucosal dissection

Authors

  • Minoru Kato

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Yoji Takeuchi

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Yasushi Yamasaki

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Masamichi Arao

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Sho Suzuki

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Taro Iwatsubo

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Kenta Hamada

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Yusuke Tonai

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Satoki Shichijo

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Noriko Matsuura

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Hiroko Nakahira

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Takashi Kanesaka

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Tomofumi Akasaka

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Noboru Hanaoka

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Koji Higashino

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Noriya Uedo

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Ryu Ishihara

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  • Hiroyasu Iishi

    Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
Further Information

Publication History

submitted 27 July 2016

accepted after revision 24 October 2016

Publication Date:
20 January 2017 (online)

Abstract

Background and study aims Complete closure of large mucosal defects after colorectal endoscopic submucosal dissection (C-ESD) is considered impossible in most cases because of the limited width of the open clip. We therefore invented a simple closure technique using clip-and-line, named “line-assisted complete closure (LACC)”, and assessed its technical feasibility.

Patients and methods Between January and February 2016, we performed LACC in 11 patients after C-ESD and included them in this retrospective feasibility study. Outcome measures were procedural success rate, procedure time, and post-procedural complications.

Results The median size of the resected specimen was 36 mm (range 30 – 72 mm). Procedural success was achieved in 10 of 11 cases (91 %). Those 10 cases required a median of 9 endoclips (range 6 – 12) for complete closure. Median procedure time for LACC was 14 minutes (range 6 – 22). No complications were observed in any of the cases after the procedure.

Conclusion LACC is a simple and feasible technique for complete closure of large mucosal defects after C-ESD.