ArticleSurgical endoscopy2023
Prophylactic clipping using the over-the-scope clip (OTSC) system after complex ESD and EMR of large colon polyps.
Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Prophylactic wound closure after ESD significantly reduces post-ESD bleeding: stratified and meta-regression analyses by tumor size and rectal proportion.Surgical endoscopy · 2026Pooled it
- Endoscopic Closure After Colorectal ESD: A Literature Review and Meta-Analysis on Its Efficacy in Preventing Adverse Events.Diagnostics (Basel, Switzerland) · 2026Review
- Traction Device-Assisted Complete Closure to Prevent Colorectal Post-ESD Coagulation Syndrome.Digestive diseases and sciences · 2026Article
- Through-the-scope twin clip for endoscopic closure of gastrointestinal defects: efficacy, safety, and factors influencing closure speed.Surgical endoscopy · 2026Observational
- Comparison Between the Efficacy of EFR and CASL in the Treatment of Small Gastric Stromal Tumors: A Retrospective Study.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Article
- Colorectal endoscopic submucosal dissection defect closure: promising but still evolving.Clinical endoscopy · 2025Article
- Unique closure of large colonic endoscopic submucosal dissection defect using zigzag clip with line pulley securing technique.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025Article
- Closure methods for large defects after gastrointestinal endoscopic submucosal dissection.Journal of gastroenterology and hepatology · 2024Review
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelayed bleeding is the most frequent complication after endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) of large colon polyps. Today, prophylactic clipping with through-the-scope clips (TTSCs) is commonly used to reduce the risk of bleeding. However, the over-the-scope clip (OTSC) system might be superior to TTSCs in achieving hemostasis. This study aims to evaluate the efficacy and safety of prophylactic clipping using the OTSC system after ESD or EMR of large colon polyps.
methodsThis is a retrospective analysis of a prospective collected database from 2009 until 2021 of three endoscopic centers. Patients with large (≥ 20 mm) colon polyps were enrolled. All polyps were removed by either ESD or EMR. After the resection, OTSCs were prophylactically applied on parts of the mucosal defect with a high risk of delayed bleeding or/and perforation. The main outcome measurement was delayed bleeding.
resultsA total of 75 patients underwent ESD (67%, 50/75) or EMR (33%, 25/75) in the colorectum. The mean resected specimen diameter was 57 mm ± 24.1 (range 22-98 mm). The mean number of OTSCs placed on the mucosal defect was 2 (range 1-5). None of the mucosal defects were completely closed. Intraprocedural bleeding occurred in 5.3% (ESD 2.0% vs. EMR 12.0%; P = 0.105), and intraprocedural perforation occurred in 6.7% (ESD 8% vs. EMR 4%; P = 0.659) of the patients. Hemostasis was achieved in 100% of cases of intraprocedural bleeding, whereas two patients required surgical conversion due to intraprocedural perforation. Among the remaining 73 patients who received prosphylactic clipping, delayed bleeding occurred in 1.4% (ESD 0% vs. EMR 4.2%; P = 0.329), and delayed perforation occurred in 0%.
conclusionsThe prophylactic partial closure of large post-ESD/EMR mucosal defects using OTSCs could serve as an effective strategy to reduce the risk of delayed bleeding and perforation. The prophylactic partial closure of large complex post-ESD/EMR mucosal defects using OTSCs could serve as an effective strategy to reduce the risk of delayed bleeding and perforation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.