Concise Commentary: Caution, Not Cauterization—Management of Post-ESD Colorectal Hemorrhage

Excerpt

Colorectal endoscopic submucosal dissection (ESD) is gaining recognition as a safe and minimally invasive procedure to remove early-stage colorectal cancer. Since colorectal ESD is often complicated by delayed bleeding in 0.5–9.5% patients, it is important for endoscopists to determine when emergency endoscopy is necessary in order to treat this complication [1]. Although massive bleeding generally requires initial endoscopic hemostasis, most cases of bleeding do not require emergency repeat colonoscopy since bleeding usually spontaneously stops within several hours and does not recur prior to hospital discharge [2]. Nevertheless, no consensus exists regarding the safe and appropriate management of delayed bleeding following ESD. …