Effect of double-layered suturing for mucosal defect closure after colorectal endoscopic submucosal dissection on...

Prophylactic closure of mucosal defects after colorectal endoscopic submucosal dissection (ESD) can reduce the incidence of postoperative adverse events. However, data on this notion are limited. This study retrospectively evaluated the effect of closure using a double-layered suturing technique on postoperative adverse events.

A total of 370 lesions in 317 patients who underwent colorectal ESD were included in this analysis. Patients with 197 lesions that were completely closed were then assigned to the closure group. Patients with 173 lesions, including 55 that were partially closed and 118 that were not closed, were assigned to the non-closure group. Propensity score matching was performed, and 136 lesions were selected for each group.

The closure group had a significantly lower overall incidence rate of postoperative adverse events, including delayed bleeding, delayed perforation, and post-ESD electrocoagulation syndrome, than the non-closure group (2.2% vs. 9.6%, p=0.018). The closure group had a significantly lower incidence of abdominal pain on the day after ESD than the non-closure group (2.9% vs. 11.0%, p=0.015).

Prophylactic closure of mucosal defects after colorectal ESD using a double-layered suturing technique could prevent postoperative adverse events and abdominal pain on the day after ESD.