Nonsurgical treatment of 8 cases with esophageal perforations caused by ESD.

BACKGROUND Esophageal perforation is a serious, but rare complication of high mortality following the endoscopic submucosal dissection (ESD) procedure. The aim of this study is to evaluate the efficacy and safety of nonsurgical treatment of esophageal perforations caused by ESD based on our clinical experience. METHODS From January 2009 to November 2013, 8 patients were diagnosed with endoscopic perforation of the esophagus caused by ESD in our center. All cases were treated with nonsurgical measures, such as metallic clips, conservative treatment alone and therapeutic drainage. RESULTS The places of perforation were closured by metallic clips immediately in 4 patients. Two patients were cured with conservative treatment alone. Therapeutic drainage with large-bore tube thoracostomy was applied in another 2 patients who had empyema following esophageal perforation. All of the patients were treated nonsurgically, and recovered well. CONCLUSION Esophageal perforation caused by ESD can be detected and treated timely, and nonsurgical treatment seems to be a feasible and effective option for clinicians.