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Hemorrhage control during gastric endoscopic submucosal dissection: Techniques using uncovered knives
Since the last decade, endoscopic submucosal dissection (ESD) has been used as the standard treatment for superficial gastrointestinal neoplasms. Trainees learning ESD frequently encounter difficulties such as vascularity, peristalsis, and fibrosis during the procedure. Because individual vascularit...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wiley Publishing Asia Pty Ltd
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008155/ https://www.ncbi.nlm.nih.gov/pubmed/32055690 http://dx.doi.org/10.1002/jgh3.12202 |
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author | Horikawa, Yohei Fushimi, Saki Sato, Sayaka |
author_facet | Horikawa, Yohei Fushimi, Saki Sato, Sayaka |
author_sort | Horikawa, Yohei |
collection | PubMed |
description | Since the last decade, endoscopic submucosal dissection (ESD) has been used as the standard treatment for superficial gastrointestinal neoplasms. Trainees learning ESD frequently encounter difficulties such as vascularity, peristalsis, and fibrosis during the procedure. Because individual vascularity differs, it generally cannot be consistently avoided. Given that massive hemorrhages can prolong the procedure time and diminish treatment efficacy and that insufficient vessel handling may also increase postoperative bleeding, hemorrhage control during ESD becomes important to ensure procedure safety. This article discusses methods for controlling hemorrhage during gastric ESD. Endoscopists should have a basic understanding of the vascular architecture and the high‐density areas in blood vessels, which are susceptible to intraoperative hemorrhage. Efficient preventative coagulation should be performed in addition to mastering the techniques for hemorrhage control using hemostatic forceps. Techniques useful for preventing intraoperative hemorrhage at every step (e.g. submucosal injection, mucosal incision, and dissection) should be learned. Gaining procedural competence and learning hemorrhage control techniques not only during ESD but also in daily work would help provide safe and effective treatment. |
format | Online Article Text |
id | pubmed-7008155 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wiley Publishing Asia Pty Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-70081552020-02-13 Hemorrhage control during gastric endoscopic submucosal dissection: Techniques using uncovered knives Horikawa, Yohei Fushimi, Saki Sato, Sayaka JGH Open Review Articles Since the last decade, endoscopic submucosal dissection (ESD) has been used as the standard treatment for superficial gastrointestinal neoplasms. Trainees learning ESD frequently encounter difficulties such as vascularity, peristalsis, and fibrosis during the procedure. Because individual vascularity differs, it generally cannot be consistently avoided. Given that massive hemorrhages can prolong the procedure time and diminish treatment efficacy and that insufficient vessel handling may also increase postoperative bleeding, hemorrhage control during ESD becomes important to ensure procedure safety. This article discusses methods for controlling hemorrhage during gastric ESD. Endoscopists should have a basic understanding of the vascular architecture and the high‐density areas in blood vessels, which are susceptible to intraoperative hemorrhage. Efficient preventative coagulation should be performed in addition to mastering the techniques for hemorrhage control using hemostatic forceps. Techniques useful for preventing intraoperative hemorrhage at every step (e.g. submucosal injection, mucosal incision, and dissection) should be learned. Gaining procedural competence and learning hemorrhage control techniques not only during ESD but also in daily work would help provide safe and effective treatment. Wiley Publishing Asia Pty Ltd 2019-06-18 /pmc/articles/PMC7008155/ /pubmed/32055690 http://dx.doi.org/10.1002/jgh3.12202 Text en © 2019 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Articles Horikawa, Yohei Fushimi, Saki Sato, Sayaka Hemorrhage control during gastric endoscopic submucosal dissection: Techniques using uncovered knives |
title | Hemorrhage control during gastric endoscopic submucosal dissection: Techniques using uncovered knives |
title_full | Hemorrhage control during gastric endoscopic submucosal dissection: Techniques using uncovered knives |
title_fullStr | Hemorrhage control during gastric endoscopic submucosal dissection: Techniques using uncovered knives |
title_full_unstemmed | Hemorrhage control during gastric endoscopic submucosal dissection: Techniques using uncovered knives |
title_short | Hemorrhage control during gastric endoscopic submucosal dissection: Techniques using uncovered knives |
title_sort | hemorrhage control during gastric endoscopic submucosal dissection: techniques using uncovered knives |
topic | Review Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008155/ https://www.ncbi.nlm.nih.gov/pubmed/32055690 http://dx.doi.org/10.1002/jgh3.12202 |
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