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Non-surgical management of microperforation induced by EMR of the stomach

G Jeong1, J H Lee, M K Yu

  • 1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50 Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|July 11, 2006
PubMed
Abstract

Insights

Management of gastric endoscopic mucosal resection microperforations is established. Non-surgical treatment, including fasting and antibiotics, leads to successful recovery for most patients with this complication.

Area of Science:

  • Gastroenterology
  • Endoscopic procedures
  • Surgical complications

Background:

  • Gastric endoscopic mucosal resection (EMR) carries risks of perforation and bleeding.
  • While evident perforations are managed with endoscopic clipping, microperforation treatment remains unclear.

Purpose of the Study:

  • To review the clinical features and outcomes of microperforations following gastric EMR.
  • To evaluate the efficacy of non-surgical management for gastric EMR-induced microperforations.

Main Methods:

  • Retrospective review of 13 patients with microperforation after gastric EMR between January 2002 and June 2004.
  • Analysis of clinical features, management strategies, and recovery outcomes.

Main Results:

  • 13 cases of microperforation were identified (3.18% of EMR procedures).
  • 11 out of 13 patients recovered without surgery, with symptoms including abdominal pain, mild discomfort, or no symptoms.
  • Leukocytosis was observed in 72.7% of patients; non-surgical management involved nasogastric tube drainage, fasting, and intravenous antibiotics.

Conclusions:

  • Gastric EMR-induced microperforation can be successfully managed non-surgically.
  • Non-surgical treatment, encompassing fasting, nasogastric tube drainage, and intravenous antibiotics, is effective.

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