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Clinical Journal of Gastroenterology

, Volume 12, Issue 1, pp 29–33 | Cite as

Successful treatment of an esophageal perforation that occurred during endoscopic submucosal dissection for esophageal cancer using polyglycolic acid sheets and fibrin glue

  • Umaporn Seehawong
  • Yoshinori MoritaEmail author
  • Yoshiko Nakano
  • Takehiro Iwasaki
  • Chonlada Krutsri
  • Hiroya Sakaguchi
  • Tomoya Sako
  • Toshitatsu Takao
  • Shinwa Tanaka
  • Takashi Toyonaga
  • Eiji Umegaki
  • Yuzo Kodama
Case Report
  • 90 Downloads

Abstract

A 74-year-old female, who was diagnosed with superficial esophageal cancer, underwent endoscopic submucosal dissection (ESD) at another hospital, but a perforation occurred during the procedure. The perforation was closed with endoscopic clips, and the ESD was halted. The patient was referred to our hospital, and ESD was retried. There was severe fibrosis around the lesion, and injections into the submucosal layer were difficult. In addition, it was not possible to identify the submucosal layer, and making an oral-side incision caused a large perforation along the incision line. As continuing the submucosal dissection with an endoknife was considered difficult, the lesion was finally resected with hybrid ESD using a snare. The perforation was closed using polyglycolic acid (PGA) sheets and fibrin glue. Endoscopy performed 6 days later showed that the defect had been closed, and no contrast leakage was detected. Follow-up endoscopy conducted 3 months after the ESD showed ulcer healing at the dissection site and scar formation, but no residual tumor or esophageal stricture was noted. Our experience suggests that the use of PGA sheets with fibrin glue is a feasible, safe, and effective way of treating large esophageal perforations during ESD.

Keywords

Endoscopic submucosal dissection Perforation Polyglycolic acid sheet 

Notes

Compliance with ethical standards

Conflict of interest

None of the authors have any conflicts of interest that are relevant to the content of this article.

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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  • Umaporn Seehawong
    • 1
  • Yoshinori Morita
    • 2
    Email author
  • Yoshiko Nakano
    • 2
  • Takehiro Iwasaki
    • 3
  • Chonlada Krutsri
    • 1
  • Hiroya Sakaguchi
    • 2
  • Tomoya Sako
    • 2
  • Toshitatsu Takao
    • 2
  • Shinwa Tanaka
    • 2
  • Takashi Toyonaga
    • 4
  • Eiji Umegaki
    • 2
  • Yuzo Kodama
    • 2
  1. 1.Department of Surgery, Faculty of Medicine, Ramathibodi HospitalMahidol UniversityBangkokThailand
  2. 2.Division of Gastroenterology, Department of Internal MedicineKobe University Graduate School of MedicineKobeJapan
  3. 3.Department of GastroenterologyJapanese Red Cross Kochi HospitalKochiJapan
  4. 4.Department of EndoscopyKobe University HospitalKobeJapan

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