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

Various methods have been developed for mucosal defect closure after colorectal endoscopic submucosal dissection (ESD), but prolonged procedure time and technical complexity remain challenges. The SureClip Traction Band (SCTB; Micro-Tech, Nanjing, China), originally designed as a traction device, has recently been used for defect closure. This study evaluated its efficacy for defect closure following colorectal ESD.

We retrospectively analyzed colorectal ESD cases (≤ 50 mm) between January 2023 and August 2025 in which SCTB was used for defect closure. The primary outcome was the complete closure rate. Secondary outcomes included closure time, numbers of SCTBs and additional clips used, and the incidence of delayed bleeding (DB), delayed perforation (DP), and post-ESD coagulation syndrome (PECS). Historical control cases (non-SCTB group) were ESDs for lesions ≤ 50 mm performed between January 2022 and March 2023.

In total, 55 lesions were closed using SCTB. The mean resected specimen size was 35.5 ± 9.0 mm, and the complete closure rate was 98.2%. The median closure time (IQR) was 8.6 (4.5) min, with an average of 1.1 ± 0.3 SCTBs and 6.6 ± 2.1 additional clips used per case. Complication rates in the SCTB versus non-SCTB groups were similar for DB (1.8% vs. 1.5%, p = 1.00) and DP (0% vs. 2.2%, p = 0.56). However, the incidence of PECS was significantly lower in the SCTB group (3.6% vs. 14.0%, p = 0.04).

Endoscopic closure using SCTB achieved a high complete closure rate with a short procedure time and reduced incidence of PECS after colorectal ESD.