Miao YD, Tang XL, Wang JT, Mi DH. Prevention of late complications of endoscopic resection of colorectal lesions with a coverage agent: Current status of gastrointestinal endoscopy. World J Gastrointest Oncol 2022; 14(2): 543-546 [PMID: 35317316 DOI: 10.4251/wjgo.v14.i2.543]
Corresponding Author of This Article
Deng-Hai Mi, MD, Chief Doctor, Dean, The First Clinical Medical College, Lanzhou University, No. 1 Donggang West Road, Chengguan District, Lanzhou 730000, Gansu Province, China. mi.dh@outlook.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
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 Gastrointest Oncol. Feb 15, 2022; 14(2): 543-546 Published online Feb 15, 2022. doi: 10.4251/wjgo.v14.i2.543
Prevention of late complications of endoscopic resection of colorectal lesions with a coverage agent: Current status of gastrointestinal endoscopy
Yan-Dong Miao, Xiao-Long Tang, Jiang-Tao Wang, Deng-Hai Mi
Yan-Dong Miao, Xiao-Long Tang, Jiang-Tao Wang, Deng-Hai Mi, The First Clinical Medical College, Lanzhou University, Lanzhou 730000, Gansu Province, China
Deng-Hai Mi, Dean's office, Gansu Academy of Traditional Chinese Medicine, Lanzhou 730000, Gansu Province, China
Author contributions: Mi DH and Miao YD designed the research; Miao YD wrote this comment; Tang XL and Wang JT made academic advice; Mi DH reviewed this manuscript; and all authors approved the final manuscript.
Conflict-of-interest statement: No conflict of interest associated with any of the senior authors or other coauthors contributed their efforts in this manuscript.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Deng-Hai Mi, MD, Chief Doctor, Dean, The First Clinical Medical College, Lanzhou University, No. 1 Donggang West Road, Chengguan District, Lanzhou 730000, Gansu Province, China. mi.dh@outlook.com
Received: June 23, 2021 Peer-review started: June 23, 2021 First decision: July 29, 2021 Revised: July 31, 2021 Accepted: January 25, 2022 Article in press: January 25, 2022 Published online: February 15, 2022 Processing time: 231 Days and 21 Hours
Abstract
Endoscopic ectomy of large nonpedunculated colorectal lesions (≥ 20 mm) might cause significant adverse incidents, such as delayed perforation and delayed bleeding, despite the closure of mucosal lesions with clips. The conventional utilization of prophylactic clipping has not decreased the risk of postprocedural delayed adverse events, and additional outcomes and cost-effectiveness research is needed for patients with proximal lesions ≥ 20 mm, in whom prophylactic clipping might be useful. Coverage of the wound after endoscopic excision offers shield protection against delayed concomitant diseases.
Core Tip: The conventional application of prophylactic clipping has not diminished overall risk of postprocedural delayed adverse events, and additional efficacy and cost-effectiveness studies are needed in patients with large (20 mm) non-pedunculated colorectal lesions, in whom prophylactic clipping may be useful. The preventive process significantly decreases the risk of delayed adverse events (delayed bleeding and delayed perforation) by more than 80%.
