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Diagnostic and Therapeutic Endoscopy
Volume 2012 (2012), Article ID 624835, 5 pages
Review Article

Management of Complications during Gastric Endoscopic Submucosal Dissection

1Internal Medicine, Daegu Fatima Hospital 183, Ayang-ro, Dong-gu, Daegu, Republic of Korea
2Internal Medicine, Kyungpook National University School of Medicine, 50 Samduk 2Ga, Chung-gu, Daegu, Republic of Korea

Received 23 June 2012; Revised 16 September 2012; Accepted 16 September 2012

Academic Editor: Won Young Cho

Copyright © 2012 Dong Wook Lee and Seong Woo Jeon. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Popularity of endoscopic submucosal dissection (ESD) has shown an increase during the last decade, and may, for the time being, be the most important technique in treatment of early gastrointestinal cancer or a premalignant lesion. This technique has advantages in the aspect of en bloc resection, which enables evaluation of the completeness of resection and other pathologic characteristics; however, it has limitation in terms of complications, compared to endoscopic mucosal resection (EMR). Bleeding and perforation are the most common complications encountered during the procedure. These complications can cause embarrassment for the endoscopist and hamper performance of the procedure, which can result in an incomplete resection. To overcome these obstacles during performance of the procedure, we should be familiar with management of complications. In particular, beginners who start performing ESD should have full knowledge of and be in good handling of the method of hemostasis using hemoclips or electrocoagulation for management of complications. Various methods, procedures, and equipment are under development, which will provide us with powerful tools for achievement of successful ESD without complications in the near future.