Indications and Techniques for Closure after Endoscopic Mucosal Resection.

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Endoscopic mucosal resection (EMR) is a common technique for removing gastrointestinal lesions.
• Delayed bleeding is a significant complication following EMR, particularly with certain resection methods and locations.

Purpose of the Study:

• To determine the necessity of defect closure after EMR.
• To review available endoscopic closure techniques for EMR defects.

Main Methods:

• Review of factors influencing the need for closure after EMR.
• Description of endoscopic closure devices and their applications.

Main Results:

• Hot snare EMR generally requires closure to mitigate delayed bleeding risk.
• The duodenum and right colon are high-risk locations for bleeding post-EMR.
• Through-the-scope clips are suitable for most defects.
• Over-the-scope clips and endoscopic suturing provide durable closure for larger defects.

Conclusions:

• Endoscopic closure is often necessary after hot snare EMR, particularly in specific anatomical locations.
• A range of endoscopic closure devices are available to manage defects of varying sizes, ensuring patient safety.