Lorenzo-Zúñiga V, Bustamante-Balén M, Pons-Beltrán V. Prevention of late complications with coverage agents in endoscopic resection of colorectal lesions: Current landscape in gastrointestinal endoscopy. World J Gastroenterol 2021; 27(15): 1563-1568 [PMID: 33958843 DOI: 10.3748/wjg.v27.i15.1563]
Corresponding Author of This Article
Vicente Lorenzo-Zúñiga, MD, PhD, Associate Professor, Consultant Physician-Scientist, Endoscopy Unit, Department of Gastroenterology, Hospital Universitari i Politècnic La Fe, Avenida Fernando Abril Martorell 106, Valencia 46026, Spain. vlorenzozuniga@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
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/
World J Gastroenterol. Apr 21, 2021; 27(15): 1563-1568 Published online Apr 21, 2021. doi: 10.3748/wjg.v27.i15.1563
Prevention of late complications with coverage agents in endoscopic resection of colorectal lesions: Current landscape in gastrointestinal endoscopy
Vicente Lorenzo-Zúñiga, Marco Bustamante-Balén, Vicente Pons-Beltrán
Vicente Lorenzo-Zúñiga, Endoscopy Unit, Department of Gastroenterology, Hospital Universitari i Politècnic La Fe, Valencia 46026, Spain
Vicente Pons-Beltrán, Digestive Diseases Department, La Fe Polytechnic University Hospital, Valencia 46026, Spain
Author contributions: Lorenzo-Zúñiga V wrote the paper; Bustamante-Balén M and Pons-Beltrán V reviewed the paper.
Conflict-of-interest statement: Authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Vicente Lorenzo-Zúñiga, MD, PhD, Associate Professor, Consultant Physician-Scientist, Endoscopy Unit, Department of Gastroenterology, Hospital Universitari i Politècnic La Fe, Avenida Fernando Abril Martorell 106, Valencia 46026, Spain. vlorenzozuniga@gmail.com
Received: December 27, 2020 Peer-review started: December 27, 2020 First decision: January 23, 2021 Revised: February 5, 2021 Accepted: March 9, 2021 Article in press: March 9, 2021 Published online: April 21, 2021 Processing time: 107 Days and 20.1 Hours
Abstract
Endoscopic removal of large (≥ 20 mm) non-pedunculated colorectal lesions (LNPCLs) may result in major adverse events, such as delayed bleeding (DB) and delayed perforation (DP), despite closure of the mucosal defects with clips. Topical application of a coverage agent refers to the creation of a shield with a biocompatible medical device (tissue or hydrogel) with proven bioactive properties. Coverage of the eschar after endoscopic resection provides shielding protection to prevent delayed complications. The aim of the present review was to systematically collect and review the currently available literature regarding the prevention of DB and DP with coverage agents after endoscopic mucosal resection or endoscopic submucosal dissection of LNPCLs.
Core Tip: The use of coverage agents is the simplest and quickest technique to protect large mucosal defects. Published data have confirmed their efficacy in the prevention of delayed adverse events in patients with non-pedunculated colorectal lesions, especially in proximal lesions with an increased risk of bleeding of at least 2-fold. There are no comparative studies that address the best treatment. We herein review the current landscape of the available agents in gastrointestinal endoscopy.
