Closure of Defects and Management of Complications

Gastrointest Endosc Clin N Am. 2019 Oct;29(4):705-719. doi: 10.1016/j.giec.2019.06.005. Epub 2019 Jul 31.

Abstract

Large and complex colon polyps are frequently referred to surgery for fear of perforation that may need emergency surgery. During the last 15 years, advances in clip and suturing devices allowed us to close perforations and avoid surgery. In addition, we have made substantial progress in our understanding of the lesions at risk for either immediate or delayed perforation. This article focuses on the colonoscopic closure of resection defects and perforations and the prevention and treatment of colon perforations after endoscopic resection.

Keywords: Clips; Closure; Colonoscopy; Endoscopic mucosal resection; Endoscopic submucosal dissection; Perforation; Suturing device.

Publication types

  • Review

MeSH terms

  • Aged
  • Colonoscopes*
  • Colonoscopy / adverse effects*
  • Colonoscopy / methods
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Female
  • Humans
  • Iatrogenic Disease
  • Intestinal Perforation / surgery*
  • Intraoperative Complications / surgery*
  • Male
  • Middle Aged
  • Prognosis
  • Surgical Instruments
  • Suture Techniques
  • Wound Closure Techniques / instrumentation