Background and study aims: Many medical institutions in Japan perform endoscopic mucosal dissection (ESD) to
treat early gastric cancer. Perforations can occur during ESD, and clipping has been
reported as useful for treating small pinhole perforations. However, it is often difficult
to close postoperative perforations because they usually have large diameters, and
the muscle layer around the perforated region is often fragile, so additional open
surgery is the only currently used method to treat large perforations and delayed
perforations. Another method for large perforation is needed to treat perforations
endoscopically. Ono et al. reported a case in which a postoperative perforation was
closed using a polyglycolic acid (PGA) sheet and fibrin glue. In addition, it has
been used by the authors’ group to repair duodenal injuries that occur during ESD.
We report 3 cases in which PGA sheets and fibrin glue were successfully used to repair
postoperative gastric perforations endoscopically. This method is simple, safe, and
effective, and is a new way to treat large perforations and delayed perforations that
occur following ESD.
