A snare combined with endoclips to assist in endoscopic submucosal dissection for intraepithelial neoplasia in the entire colon and rectum
Autor: | Qiang Zhang, Zhen Wang, Tong-Yin Xing |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male China medicine.medical_specialty Endoscopic Mucosal Resection genetic structures Colon medicine.medical_treatment Operative Time Rectum Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Traction Humans Medicine Aged Retrospective Studies Intraepithelial neoplasia Entire colon business.industry Gastroenterology Colonoscopy Endoscopic submucosal dissection Middle Aged Traction (orthopedics) digestive system diseases Endoclip medicine.anatomical_structure 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Radiology Colorectal Neoplasms business |
Zdroj: | Scandinavian Journal of Gastroenterology. 54:114-121 |
ISSN: | 1502-7708 0036-5521 |
Popis: | The use of mucosal traction to assist in colonic and rectal endoscopic submucosal dissection (ESD), especially for deep colonic ESD, is challenging. We developed a method of inverse insertion of a snare into the endoscopic working channel to deliver it into the colon together with the endoscope. With this method, two types of mucosal traction, per-anal external traction (PET) and per-anal internal traction (PIT), could be achieved using a snare with endoclips to assist in ESD (ESD-SE). Here, we aimed to examine its safety and feasibility.From January 2017 to September 2018, 50 colonic and rectal intraepithelial neoplasias in 50 patients were treated with ESD-SE. Data on lesion location and size, operation time, en bloc resection and R0 resection rates, and operative complications were collected.Among 50 lesions, 15 lesions were located in the deep colon/proximal colon, and 35 lesions were in the distal colon. The median (interquartile range) size of lesions, submucosal dissection time, and total operation time were 4.5 (3.0-5.0) cm, 32 (18-81) min, and 50 (33-108) min, respectively. All lesions were completely resected, with R0 resection rates of 100%. No intraoperative and postoperative complications occurred. Postoperative pathology revealed 40 and 10 cases of high-grade and low-grade intraepithelial neoplasia, respectively.The approach using insertion of a selective snare into the colon together with the endoscope, especially into the deep colon, was safe and simple. Use of the snare combined with endoclips could effectively assist in total colonic ESD. Further research is warranted. |
Databáze: | OpenAIRE |
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