Abstract
Management of bleeding is crucial for a successful endoscopic submucosal dissection (ESD) with the Flex knife for a stomach neoplasm. Medical approaches to suppress gastric acid secretion and keep systolic blood pressure at the level of < 150 mmHg during ESD are tried to lessen bleeding. But, major concerns for bleeding are whether the blood vessels are cut off or not and endoscopic surgeons have to avoid blind application of devices for ESD as much as possible. Even in the situations where blind application for non-visible vessels in the submucosa is not preventable such as in the steps of marking, submucosal injection, mucosal incision, and snaring, the efforts to lessen bleeding are necessary. When non-bleeding visible vessels are noticed, 'prebleeding coagulation' with appropriate devices is important. Even if unexpected bleeding occurs, it is also controllable using appropriate devices according to the type of bleeding. All endscopists who perform ESD should also be experts in management of bleeding.
| Original language | English |
|---|---|
| Journal | Digestive Endoscopy |
| Volume | 18 |
| Issue number | SUPPL. 1 |
| DOIs | |
| Publication status | Published - 2006 Jul |
| Externally published | Yes |
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Keywords
- Bleeding
- Endoscopic submucosal dissection
- Flex knife
- Hemostasis
- Stomach neoplasm
ASJC Scopus subject areas
- Gastroenterology
Cite this
Management of bleeding concerning endoscopic submucosal dissection with the flex knife for stomach neoplasm. / Fujishiro, Mitsuhiro; Yahagi, Naohisa; Kakushima, Naomi; Kodashima, Shinya; Muraki, Yosuke; Tateishi, Ayako; Omata, Masao.
In: Digestive Endoscopy, Vol. 18, No. SUPPL. 1, 07.2006.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Management of bleeding concerning endoscopic submucosal dissection with the flex knife for stomach neoplasm
AU - Fujishiro, Mitsuhiro
AU - Yahagi, Naohisa
AU - Kakushima, Naomi
AU - Kodashima, Shinya
AU - Muraki, Yosuke
AU - Tateishi, Ayako
AU - Omata, Masao
PY - 2006/7
Y1 - 2006/7
N2 - Management of bleeding is crucial for a successful endoscopic submucosal dissection (ESD) with the Flex knife for a stomach neoplasm. Medical approaches to suppress gastric acid secretion and keep systolic blood pressure at the level of < 150 mmHg during ESD are tried to lessen bleeding. But, major concerns for bleeding are whether the blood vessels are cut off or not and endoscopic surgeons have to avoid blind application of devices for ESD as much as possible. Even in the situations where blind application for non-visible vessels in the submucosa is not preventable such as in the steps of marking, submucosal injection, mucosal incision, and snaring, the efforts to lessen bleeding are necessary. When non-bleeding visible vessels are noticed, 'prebleeding coagulation' with appropriate devices is important. Even if unexpected bleeding occurs, it is also controllable using appropriate devices according to the type of bleeding. All endscopists who perform ESD should also be experts in management of bleeding.
AB - Management of bleeding is crucial for a successful endoscopic submucosal dissection (ESD) with the Flex knife for a stomach neoplasm. Medical approaches to suppress gastric acid secretion and keep systolic blood pressure at the level of < 150 mmHg during ESD are tried to lessen bleeding. But, major concerns for bleeding are whether the blood vessels are cut off or not and endoscopic surgeons have to avoid blind application of devices for ESD as much as possible. Even in the situations where blind application for non-visible vessels in the submucosa is not preventable such as in the steps of marking, submucosal injection, mucosal incision, and snaring, the efforts to lessen bleeding are necessary. When non-bleeding visible vessels are noticed, 'prebleeding coagulation' with appropriate devices is important. Even if unexpected bleeding occurs, it is also controllable using appropriate devices according to the type of bleeding. All endscopists who perform ESD should also be experts in management of bleeding.
KW - Bleeding
KW - Endoscopic submucosal dissection
KW - Flex knife
KW - Hemostasis
KW - Stomach neoplasm
UR - http://www.scopus.com/inward/record.url?scp=33845540045&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33845540045&partnerID=8YFLogxK
U2 - 10.1111/j.1443-1661.2006.00638.x
DO - 10.1111/j.1443-1661.2006.00638.x
M3 - Article
AN - SCOPUS:33845540045
VL - 18
JO - Digestive Endoscopy
JF - Digestive Endoscopy
SN - 0915-5635
IS - SUPPL. 1
ER -