BACKGROUND AND AIMS: Despite advances in endoscopic submucosal dissection (ESD), perforation can still occur. The purpose of this study is to determine the clinical course and effectiveness of endoscopic closure in addition to the clinicopathological features related to perforation. METHODS: A total of 935 lesions in 900 consecutive @entity1 between February 1998 and February 2013 underwent ESD for @entity14 at our institution. We studied the clinical course and histological features of perforation through a matched case-control study that included 24 @entity1 with intra-procedural perforation and 240 matched @entity1 without perforation as a control group. Endoscopic closure using through-the-scope endoclips was attempted in all cases of intra procedural perforations immediately after perforation was recognized during procedure. RESULTS: Perforation occurred in 25 cases (2.7%), including 24 intra-procedural and one delayed perforation. All but one @entity1 with intra-procedural perforation was conservatively managed by endoscopic closure. One @entity1 with unsuccessful endoscopic closure required emergency surgery. Analysis of clinical course revealed statistically significant differences (P<0.01) between the @entity1 with perforation and the case controlled non-perforation @entity1 in total procedure time, white blood cell count (WBC) and level of serum @entity1851 ( @entity1851 ) on the day after procedure, admission period and fasting period. Both location (P=0.027) and @entity82 (P=0.04) of the lesion were significantly associated with perforation. Multivariate analysis revealed that @entity82 was a significant risk factor associated with perforation (Odds ratio, 2.86; 95% CI, 1.03 to 7.90). CONCLUSIONS: Endoscopic closure allows effective non-surgical management in cases of intra-procedural perforation during ESD.

Clinical impact of endoscopic clip closure of perforations during endoscopic submucosal dissection for XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity82 :: ('MESH:D005355', 'Disease') :: ['submucosal fibrosis', 'fibrosis'] @entity14 :: ('MESH:D015179', 'Disease') :: ['colorectal tumors'] @entity1851 :: ('1401', 'Gene') :: ['C-reactive protein', 'CRP']
@entity14 :: (MESH:D015179,Disease) :: ['colorectal tumors']
