Traction Device-Assisted Complete Closure to Prevent Colorectal Post-ESD Coagulation Syndrome.

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Medical Devices

Background:

• Colorectal endoscopic submucosal dissection (ESD) requires effective mucosal defect closure.
• Existing methods face challenges in procedure time and technical complexity.
• The SureClip Traction Band (SCTB) is a novel device for defect closure.

Purpose of the Study:

• To evaluate the efficacy of the SureClip Traction Band (SCTB) for mucosal defect closure after colorectal ESD.
• To compare the SCTB method with historical control cases (non-SCTB group).

Main Methods:

• Retrospective analysis of colorectal ESD cases (lesions ≤ 50 mm) using SCTB for defect closure.
• Primary outcome: complete closure rate.
• Secondary outcomes: closure time, device usage, and complication rates (delayed bleeding, delayed perforation, post-ESD coagulation syndrome).

Main Results:

• A total of 55 lesions were closed using SCTB, with a complete closure rate of 98.2%.
• The median closure time was 8.6 minutes, using an average of 1.1 SCTBs and 6.6 additional clips.
• Complication rates for delayed bleeding and perforation were similar to the non-SCTB group, but post-ESD coagulation syndrome (PECS) was significantly lower (3.6% vs. 14.0%).

Conclusions:

• Endoscopic closure with SCTB is highly effective for colorectal ESD defects.
• The SCTB method offers a short procedure time and a reduced incidence of PECS.
• SCTB demonstrates a promising alternative for defect closure in colorectal ESD.