Endoscopic mucosal resection with the grasp-and-snare technique through a double-channel endoscope in humans
| Autor: | Massimo Raimondo, Timothy A. Woodward, Michael B. Wallace, Patrick W. Cleveland, Silvio W. de Melo |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Endoscope Perforation (oil well) Argon plasma coagulation Endoscopic mucosal resection Endoscopy Gastrointestinal Biopsy medicine Humans Radiology Nuclear Medicine and imaging Intestinal Mucosa Gastrointestinal Polyp Aged Retrospective Studies medicine.diagnostic_test business.industry Gastroenterology Intestinal Polyps Equipment Design Surgery Endoscopy Endoscopes Gastrointestinal Treatment Outcome Female Complication business Follow-Up Studies |
| Zdroj: | Gastrointestinal Endoscopy. 73:349-352 |
| ISSN: | 0016-5107 |
| Popis: | Background EMR is being used to manage premalignant lesions of the GI tract. Lifting of the lesion is required to perform EMR. Earlier biopsy or snare may cause scarring and preclude adequate lifting. Objective We report our experience with a novel grasp-and-snare EMR technique that can be used when a good lifting is not achieved or the location of the lesion is challenging for standard EMR, such as in a fold. Design Single-center case series. Setting Tertiary referral academic gastroenterology unit. Patients Patients referred for endoscopic treatment of flat gastrointestinal polyps. Interventions Single-session EMR performed with a grasp-and-snare technique through a double-channel gastroscope or colonoscope. Main Outcome Measurements Technical success, complication rates, and recurrence rates. Results Seventeen patients with flat gastrointestinal polyps were referred: mean age 70 years, 11 (65%) male, polyp size 0.8 to 6 cm; 13 colonic, 2 duodenal, 1 gastric, and 1 esophageal EMR performed with grasp-and-snare technique in single sessions. Six polyps (35%) did not lift after injection of hydroxypropylmethylcellulose. Fourteen polyps (82%) were resected completely. Two complications occurred (12%): 1 bleeding treated medically and 1 perforation treated surgically. Residual disease at 1 year was 18%, but 8 patients (47%) had not yet had their 1-year follow-up. Limitations Single-center, uncontrolled, not randomized. Limited follow-up. Conclusions The grasp-and-snare technique can be used to perform EMR with good outcomes and low complication rates in areas where poor lifting and accessibility are problems. |
| Databáze: | OpenAIRE |
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