ASGE Interventional IBD: Management of Complications (On-Demand)| March 2022-Damage Control: Rescue Endoscopy for Endoscopy-associated Complications

Video Transcription

Video Summary

The speaker begins by thanking the participants and sponsors of the session. They introduce Dr. G.S. Raju as the leading expert in endoscopic management of endoscopy-associated perforation. The speaker mentions that bleeding used to be a major concern in the past, but advancements in techniques have made it manageable. They emphasize the need to stay away from complications and discuss the impact of advancing age on colonoscopy, particularly the increased risk of vascular events in older patients. The speaker advises considering the risks of vascular events rather than bleeding and perforation when deciding whether to perform a colonoscopy on older patients. They also highlight the increased risk of perforation in patients with IBD, particularly those with advancing age, severe disease, and long-term steroid use.<br /><br />The speaker discusses the prevalence of complications related to colonoscopy and the improvements in safety over the years. They mention the impact of interventions on complication rates and the need to inform patients about the risks based on the severity of the procedure. The speaker briefly touches upon the limited data on complications in IBD patients. They also provide tips on preventing and managing perforations during colonoscopy, such as taking precautions with sigmoid perforation, using water immersion technique, and using thinner instruments for difficult sigmoid colon navigation. The speaker discusses the management of strictures in IBD patients, emphasizing the importance of correctly identifying and classifying the type of stricture for effective treatment. They also mention the use of covered stents for managing strictures. The speaker shares tips on preventing complications during polyp resection, including keeping the snare parallel to the wall and ensuring deep closure to avoid muscle entrapment and the risk of delayed perforation. They also discuss the management of complications such as perforation, post-polypectomy bleeding, and the use of clips for closure. The speaker mentions the potential benefits of self-assembling peptides for preventing bleeding after resection. In conclusion, they reassure that colonoscopy complications can be managed safely.

Asset Subtitle

Gottumukkala S. Raju, MD, FASGE

Keywords

endoscopic management

complications

advancing age

vascular events

IBD

strictures

polyp resection