Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Apr 25, 2016; 8(8): 368-373
Published online Apr 25, 2016. doi: 10.4253/wjge.v8.i8.368
Delayed perforation after endoscopic submucosal dissection for early gastric cancer: Clinical features and treatment
Takafumi Yano, Satoshi Tanabe, Kenji Ishido, Mizutomo Azuma, Takuya Wada, Mizuto Suzuki, Natsuko Kawanishi, Sakiko Yamane, Tohru Sasaki, Chikatoshi Katada, Tetsuo Mikami, Natsuya Katada, Wasaburo Koizumi
Takafumi Yano, Kenji Ishido, Mizutomo Azuma, Takuya Wada, Mizuto Suzuki, Natsuko Kawanishi, Sakiko Yamane, Tohru Sasaki, Chikatoshi Katada, Wasaburo Koizumi, Department of Gastroenterology, Kitasato University School of Medicine, Kanagawa 252-0375, Japan
Satoshi Tanabe, Research and Development Center for New Frontiers, Kitasato University School of Medicine, Kanagawa 252-0374, Japan
Tetsuo Mikami, Department of Pathology, Toho University School of Medicine, Tokyo 143-8540, Japan
Natsuya Katada, Department of Surgery, Kitasato University School of Medicine, Kanagawa 252-0374, Japan
Author contributions: Yano T and Tanabe S designed the report and analyzed the data and wrote the paper; Ishido K, Azuma M, Wada T, Suzuki M, Kawanishi N, Yamane S, Sasaki T, Katada C, Mikami T, Katada N and Koizumi W collected the patient’s clinical data.
Institutional review board statement: This retrospective study was approved by the Institutional Review Board of Kitasato University.
Informed consent statement: Informed consent has been obtained publishing website or posting infomation in our hospital.
Conflict-of-interest statement: All other authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Takafumi Yano, Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan. yano1371@kitasato-u.ac.jp
Telephone: +81-42-7788111 Fax: +81-42-7788390
Received: October 26, 2015
Peer-review started: October 27, 2015
First decision: December 22, 2015
Revised: December 29, 2015
Accepted: February 23, 2016
Article in press: February 24, 2016
Published online: April 25, 2016
Abstract

Perforation is an important procedural complication of endoscopic submucosal dissection (ESD) for early gastric cancer. Although the incidence of delayed perforation after ESD is low, extreme caution is necessary because many cases require surgical intervention. Among 1984 lesions of early gastric cancer treated in our hospital by ESD in 1588 patients from September 2002 through March 2015, delayed perforation developed in 4 patients (4 lesions, 0.25%). A diagnosis of delayed perforation requires prompt action, including surgical intervention when required.

Keywords: Endoscopic submucosal dissection, Early gastric cancer, Delayed perforation

Core tip: Delayed perforation is a serious complication of endoscopic submucosal dissection for early gastric cancer. A diagnosis of delayed perforation requires prompt action, including surgical intervention when required.