ASGE/JGES Advanced ESD (On-demand)| July 2023-Complex ESD Case- Learn from Mistakes and Difficult Cases

Video Transcription

Video Summary

In this video, a case is presented where the patient initially underwent a colonoscopy and a small ulcerated lesion was found. The lesion was biopsied and found to have high-grade dysplasia. The patient was recommended for surgery, but they decided to look for alternative options and were referred for endoscopic submucosal dissection (ESD). During the ESD, there was a perforation, but it was successfully closed with a clip. The procedure was continued and the remaining lesion was resected. The patient had no abdominal pain and was monitored closely. After the procedure, the patient was given antibiotics and their food intake was restricted for two days. The patient's recovery was closely monitored with daily CT scans and blood tests. The use of various techniques such as coagulation and traction devices was highlighted in the video. The importance of recognizing and managing perforations during ESD was emphasized. The video also discussed the practice of completely closing defects in colonic ESD, particularly for lesions larger than two centimeters, to reduce the risk of bleeding and delayed perforation. Overall, the importance of careful monitoring and communication with the surgical team was highlighted throughout the presentation. No specific credits were granted in the video.

Keywords

colonoscopy

ulcerated lesion

high-grade dysplasia

surgery

endoscopic submucosal dissection

perforation

clip closure

resection

antibiotics

recovery monitoring

coagulation and traction devices