Surgical Endoscopy

, Volume 24, Issue 4, pp 911–916

Clinical outcomes for perforations during endoscopic submucosal dissection in patients with gastric lesions

  • Seong Woo Jeon
  • Min Kyu Jung
  • Sung Kook Kim
  • Kwang Bum Cho
  • Kyung Sik Park
  • Chang Keun Park
  • Joong Goo Kwon
  • Jin Tae Jung
  • Eun Young Kim
  • Tae Nyeun Kim
  • Byung Ik Jang
  • Chang Hun Yang
Article

DOI: 10.1007/s00464-009-0693-y

Cite this article as:
Jeon, S.W., Jung, M.K., Kim, S.K. et al. Surg Endosc (2010) 24: 911. doi:10.1007/s00464-009-0693-y

Abstract

Background

The endoscopic submucosal dissection (ESD) technique has been gaining popularity, with continued advances in this treatment approach. However, ESD still is associated with potential complications such as severe bleeding and perforation.

Methods

This study was performed to compare the clinical outcomes for macro- and microperforations with ESD procedures and to determine the short-term prognosis after ESD. A macroperforation was defined as a gross perforation that occurred during an ESD procedure, and a microperforation was defined by free air observed on simple radiography after the procedure. Immediate closure of macroperforations was performed using endoclips. From July 2003 through May 2008, 1,711 patients underwent ESD for gastric lesions such as dysplasia, early cancer, and subepithelial lesions.

Results

Among 39 perforation cases (2.3%), macroperforations occurred for 26 patients (67%) and microperforations for 13 patients (33%). All the patients except one who underwent emergency surgery because of severe bleeding and perforation during ESD were managed successfully by intravenous antibiotics and no oral intake. The clinical prognosis and endoscopic characteristics of the patients with macroperforations did not differ from those of the patients with microperforations.

Conclusions

Perforations associated with ESD could be managed safely and successfully by nonsurgical methods. The clinical prognoses for macro- and microperforations were favorable and comparable.

Keywords

Gastroscopic surgical procedurePneumoperitoneumStomach neoplasia

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Seong Woo Jeon
    • 1
  • Min Kyu Jung
    • 1
  • Sung Kook Kim
    • 1
  • Kwang Bum Cho
    • 2
  • Kyung Sik Park
    • 2
  • Chang Keun Park
    • 3
  • Joong Goo Kwon
    • 4
  • Jin Tae Jung
    • 4
  • Eun Young Kim
    • 4
  • Tae Nyeun Kim
    • 5
  • Byung Ik Jang
    • 5
  • Chang Hun Yang
    • 6
  1. 1.Department of Internal MedicineKyungpook National University School of MedicineDaeguSouth Korea
  2. 2.Department of Internal MedicineKeimyung University College of MedicineDaeguSouth Korea
  3. 3.Department of Internal MedicineFatima HospitalDaeguSouth Korea
  4. 4.Department of Internal MedicineDaegu Catholic University School of MedicineDaeguSouth Korea
  5. 5.Department of Internal MedicineYoungnam University School of MedicineDaeguSouth Korea
  6. 6.Department of Internal MedicineDongguk University School of MedicineGyeongjuSouth Korea