Intraoperative and Delayed Perforation During Endoscopic Submucosal Dissection (ESD): Definition and Management

Intraoperative perforation was defined as the occurrence of serosal rupture during ESD. Delayed perforation was characterized by the sudden onset of abdominal pain, accompanied by the presence of intraperitoneal free gas on an abdominal CT scan. Other potential indicators of delayed perforation included fever, leukocytosis, and abdominal distension, all of which were observed retrospectively. Once a perforation was detected, it was immediately repaired using endoscopic clips or surgical intervention as deemed necessary.