Sekiguchi M, Suzuki H, Oda I, Yoshinaga S, Nonaka S, Saka M, Katai H, Taniguchi H, Kushima R, Saito Y. Dehiscence following successful endoscopic closure of gastric perforation during endoscopic submucosal dissection. World J Gastroenterol 2012; 18(31): 4224-4227 [PMID: 22919258 DOI: 10.3748/wjg.v18.i31.4224]
Corresponding Author of This Article
Haruhisa Suzuki, MD, Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. harusuzu@ncc.go.jp
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Masau Sekiguchi, Haruhisa Suzuki, Ichiro Oda, Shigetaka Yoshinaga, Satoru Nonaka, Yutaka Saito, Endoscopy Division, National Cancer Center Hospital, Tokyo 104-0045, Japan
Makoto Saka, Hitoshi Katai, Gastric Surgery Division, National Cancer Center Hospital, Tokyo 104-0045, Japan
Hirokazu Taniguchi, Ryoji Kushima, Pathology Division, National Cancer Center Hospital, Tokyo 104-0045, Japan
Author contributions: Sekiguchi M, Suzuki H, and Oda I designed the study, analyzed and interpreted the data, and drafted the article; Yoshinaga S, Nonaka S, Saka M, Katai H, Taniguchi H, Kushima R, and Saito Y contributed to the discussion and reviewed the manuscript; all the authors had final approval of the article.
Correspondence to: Haruhisa Suzuki, MD, Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. harusuzu@ncc.go.jp
Telephone: +81-3-35422511 Fax: +81-3-35423815
Received: March 1, 2012 Revised: April 17, 2012 Accepted: April 20, 2012 Published online: August 21, 2012
Abstract
Gastric perforation is one of the most serious complications that can occur during endoscopic submucosal dissection (ESD). In terms of the treatment of such perforations, we previously reported that perforations immediately observed and successfully closed with endoclips during endoscopic resection could be managed conservatively. We now report the first case in our medical facility of a gastric perforation during ESD that was ineffectively treated conservatively even after successful endoscopic closure. In December 2006, we performed ESD on a recurrent early gastric cancer in an 81-year-old man with a medical history of laparotomy for cholelithiasis. A perforation occurred during ESD that was immediately observed and successfully closed with endoclips so that ESD could be continued resulting in an en-bloc resection. Intensive conservative management was conducted following ESD, however, an endoscopic examination five days after ESD revealed dehiscence of the perforation requiring an emergency laparotomy.
