Chen YM, Xu ZL, Wang LS, Zou ZY. Sprayed tissue adhesive prevents post-endoscopic submucosal dissection bleeding in massive early gastric cancer: A case report. World J Gastrointest Endosc 2026; 18(9): 124149 [DOI: 10.4253/wjge.124149]
Corresponding Author of This Article
Zhi-Yuan Zou, Department of Gastroenterology, Shenzhen People’s Hospital (The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University), No. 1017 Dongmen North Road, Luohu District, Shenzhen 518020, Guangdong Province, China. 576517769@qq.com
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Gastroenterology & Hepatology
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case-report
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Chen YM, Xu ZL, Wang LS, Zou ZY. Sprayed tissue adhesive prevents post-endoscopic submucosal dissection bleeding in massive early gastric cancer: A case report. World J Gastrointest Endosc 2026; 18(9): 124149 [DOI: 10.4253/wjge.124149]
World J Gastrointest Endosc. Sep 16, 2026; 18(9): 124149 Published online Sep 16, 2026. doi: 10.4253/wjge.124149
Sprayed tissue adhesive prevents post-endoscopic submucosal dissection bleeding in massive early gastric cancer: A case report
Yi-Ming Chen, Zheng-Lei Xu, Li-Sheng Wang, Zhi-Yuan Zou
Yi-Ming Chen, Zheng-Lei Xu, Li-Sheng Wang, Zhi-Yuan Zou, Department of Gastroenterology, Shenzhen People’s Hospital (The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University), Shenzhen 518020, Guangdong Province, China
Author contributions: Chen YM collected clinical data and drafted the manuscript; Zou ZY and Xu ZL performed gastric ESD procedures; Wang LS critically revised the manuscript; and all authors have read and approved the final version.
AI contribution statement: We used DeepSeek for language polishing and formatting only. No AI tool was used for data analysis, result interpretation, or conclusion drawing. All content was reviewed and finalized by the authors, who bear full responsibility.
Supported by Sanming Project of Medicine in Shenzhen, No. SZSM202211029.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Zhi-Yuan Zou, Department of Gastroenterology, Shenzhen People’s Hospital (The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University), No. 1017 Dongmen North Road, Luohu District, Shenzhen 518020, Guangdong Province, China. 576517769@qq.com
Received: June 9, 2026 Revised: August 4, 2026 Accepted: August 26, 2026 Published online: September 16, 2026 Processing time: 94 Days and 16.3 Hours
Abstract
BACKGROUND
Endoscopic submucosal dissection (ESD) is the standard endoscopic resection technique for early gastric cancer (EGC). However, postoperative bleeding remains a frequent and clinically significant complication, especially after resection of large or extensively distributed lesions. Conventional hemostatic modalities, including titanium clips and endoloop ligation, often prove insufficient for achieving durable hemostasis and resection defect coverage across extensive mucosal defects. Sprayed tissue adhesive represents an emerging adjunctive strategy offering rapid, conformal sealing of large denuded surfaces.
CASE SUMMARY
A 59-year-old man presented with a large, diffusely infiltrating EGC lesion involving the gastric body, angulus, and antrum. ESD was performed, resulting in a 60 mm × 100 mm resection defect that could not be closed with endoscopic clips or sutures. Tissue adhesive was sprayed onto the defect surface, and the patient received postoperative proton pump inhibitor therapy. No immediate or delayed bleeding was observed during hospitalization or subsequent follow-up. A 4-month follow-up endoscopy revealed a wellhealed scar without evidence of recurrence or delayed bleeding.
CONCLUSION
Sprayed tissue adhesive safely and effectively aids prevention of post-ESD bleeding in large mucosal defects unsuitable for standard closure.
Core Tip: Sprayed tissue adhesive effectively prevents post-endoscopic submucosal dissection bleeding in massive early gastric cancer with extensive mucosal defects, where clipping is infeasible. It is simple, covers large areas, and may be used as an adjunct or rescue therapy for refractory bleeding.
