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Related Experiment Video

Updated: Mar 3, 2026

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
04:05

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy

Published on: August 22, 2025

977

Evaluation of Delayed Bleeding Prevention and Sustained Closure Using the Reopenable Clip-Over-the-Line Method for

Gen Kitahara1, Takuya Wada1, Kenta Murotani2,3

  • 1Department of Gastroenterology Kitasato University School of Medicine Kanagawa Japan.

DEN Open
|March 2, 2026
PubMed
Summary

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The reopenable clip-over-the-line method (ROLM) prevented delayed bleeding after gastric endoscopic submucosal dissection (ESD) in high-risk patients. This novel closure technique achieved complete closure and clip retention, showing promise for preventing complications.

Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Surgical Complications

Background:

  • Delayed bleeding is a significant complication following gastric endoscopic submucosal dissection (ESD).
  • High-risk patients undergoing gastric ESD face increased risks of post-procedural bleeding.
  • The efficacy and durability of the novel reopenable clip-over-the-line method (ROLM) for closure after gastric ESD require evaluation.

Purpose of the Study:

  • To evaluate the impact of the reopenable clip-over-the-line method (ROLM) on delayed bleeding after gastric ESD.
  • To assess the sustained closure and clip retention rates associated with ROLM in high-risk patients.

Main Methods:

  • Retrospective review of gastric ESD cases in high-risk patients (BEST-J score ≥3) from April 2021 to December 2024.
Keywords:
bleedingendoscopic submucosal dissectiongastric neoplasmssutureswound closure techniques

Related Experiment Videos

Last Updated: Mar 3, 2026

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
04:05

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy

Published on: August 22, 2025

977
  • Comparison of outcomes between patients treated with ROLM and those without (non-ROLM).
  • Assessment of delayed bleeding within 28 days, sustained closure on postoperative day 1 (POD1), and clip retention at 2 months.

    • Main Results:

    • No delayed bleeding occurred in the ROLM group (0/15 patients) compared to 23.6% in the non-ROLM group (17/72 patients) (p=0.036).
    • All lesions in the ROLM group achieved sustained closure on POD1 (100%).
    • Clip retention at 2 months was observed in 80.9% of ROLM cases.

    Conclusions:

    • The reopenable clip-over-the-line method (ROLM) is associated with zero delayed bleeding in high-risk gastric ESD patients.
    • ROLM ensures complete mucosal closure on POD1 and demonstrates favorable clip retention at 2 months.
    • ROLM presents a promising prophylactic strategy for preventing delayed bleeding after gastric ESD in high-risk individuals.