Management of perforations during endoscopic resection

Best Pract Res Clin Gastroenterol. 2024 Mar:69:101900. doi: 10.1016/j.bpg.2024.101900. Epub 2024 Feb 27.

Abstract

Despite the evolution in tools and techniques, perforation is still one of the most pernicious adverse events of therapeutic endoscopy with potentially huge consequences. As advanced endoscopic resection techniques are worldwide spreading, endoscopists must be ready to manage intraprocedural perforations. In fact, immediate endoscopic closure through a prompt diagnosis represents the first-line option, saving patients from surgery, long hospitalizations and worse outcomes. Traditional and novel endoscopic closure modalities, including clips, suturing devices, stents and vacuum therapy, are increasingly expanding the therapeutic armamentarium for closing these defects. Nevertheless, available literature on this topic is currently limited. In this review our goal is to give an overview on the management of perforations occurring during endoscopic resections, with particular attention to characteristics, advantages, disadvantages and new horizons of endoscopic closure tools.

Keywords: Cancer; Colonoscopy; Innovation; Screening; Technology.

Publication types

  • Review

MeSH terms

  • Humans
  • Intestinal Perforation* / etiology
  • Intestinal Perforation* / surgery
  • Intestinal Perforation* / therapy
  • Intraoperative Complications / etiology
  • Intraoperative Complications / therapy
  • Negative-Pressure Wound Therapy / adverse effects
  • Practice Guidelines as Topic
  • Stents
  • Surgical Instruments
  • Suture Techniques / adverse effects
  • Treatment Outcome