Effect of prior biopsy sampling, tattoo placement, and snare sampling on endoscopic resection of large nonpedunculated colorectal lesions

Kim, Hyun Gun; Thosani, Nirav; Banerjee, Subhas; Chen, Ann; Friedland, Shai

doi:10.1016/j.gie.2014.08.038

Cited by 63 publications

(54 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unfinished resection attempts render subsequent endoscopic resection both considerably more difficult and less effective, which, combined with more delayed recurrences, will inevitably drive up costs. 4 To avoid these undesirable consequences of incomplete resection, the first attempt should always aim for complete excision. This requires total commitment, making certain that all necessary staff, expertise, resources, and time are available before beginning work on a large polyp.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Look, but don’t touch: what not to do in managing large colorectal polyps

Grimm

McGill

2019

Gastrointestinal Endoscopy

View full text Add to dashboard Cite

mentioning

confidence: 99%

“…This can lead to submucosal fibrosis and complicate subsequent resection attempts. 4 Tattoos are rarely necessary for endoscopic localization of large polyps, especially when cecal landmarks are in view. They can be helpful in locating subtle lesions and polyps located behind folds.…”

mentioning

confidence: 99%

Look, but don’t touch: what not to do in managing large colorectal polyps

Grimm

McGill

2019

Gastrointestinal Endoscopy

View full text Add to dashboard Cite

“…A severely disrupted type Vn pit pattern with dye (Kudo classification), or NICE (NarrowBand Imaging International Colorectal Endoscopic) classification type 3 appearance (absent or irregularly thickened vessels) using NBI alerts the endo scopist to the possibility of deeply invasive submucosal malignancy 19 46,47 . The exception to this approach is a lesion that has been partially resected, or extensively biopsied previously, so that scarring has caused fibrosis and submucosal tethering at one or more points across the lesion 48,49 . Here, complete removal of a benign lesion is still possible and preferable to sur gery, although often with a need for EMR with thermal ablation or complex ESD 50,51 .…”

Section: Lesion Assessmentmentioning

confidence: 99%

“…The location of all polyps >2 cm, or those suspected of containing invasive cancer, should be marked with one or more India ink tattoos, placed several centimetres distal to the lesion. Care is necessary to avoid placement of the fibrogenic ink into the submucosal polypectomy defect 48,81 .…”

Section: Emr Techniquementioning

confidence: 99%

Endoscopic mucosal resection and endoscopic submucosal dissection of large colonic polyps

Saunders

Tsiamoulos

2016

Nat Rev Gastroenterol Hepatol

View full text Add to dashboard Cite

Almost all large and complex colorectal polyps can now be resected endoscopically. Piecemeal endoscopic mucosal resection (PEMR) is an established technique with fairly low complication risk and good short-term and medium-term outcomes. Several modifications to the basic injection and snare technique have been developed contributing to safer and more complete resections. Delayed bleeding requiring reintervention is the most troublesome complication in 2-7% of patients, particularly in those with comorbidities and large, right-sided polyps. Endoscopic submucosal dissection (ESD) has become popular in Japan and has theoretical advantages over PEMR in providing a complete, en bloc excision for accurate histological staging and reduced local recurrence. These advantages come at the cost of a more complex, expensive and time-consuming procedure with a higher risk of perforation, particularly early in the procedure learning curve. These factors have contributed to the slow adoption of ESD in the West and the challenge to develop new devices and endoscopic platforms that will make ESD easier and safer. Currently, ESD indications are limited to large rectal lesions, in which procedural complications are easily managed, and for colorectal polyps with a high risk of containing tiny foci of early submucosally invasive cancer, whereby ESD may be curative compared with PEMR.

show abstract

“…It is also a valuable technique in resecting lesions with profound submucosal fibrosis from previous resection or heavy manipulation, which is common in western practice 21. The patient population, referral patterns, case load for the relatively few experienced interventional colorectal endoscopists and lesion characteristics are likely to be substantially different from eastern practice.…”

Section: Introductionmentioning

confidence: 99%

Colorectal endoscopic submucosal dissection: patient selection and special considerations

Emmanuel¹,

Gulati²,

Burt³

et al. 2017

CEG

View full text Add to dashboard Cite

Endoscopic submucosal dissection (ESD) enables en bloc resection of large complex colorectal superficial neoplastic lesions, resulting in very low rates of local recurrence, high-quality pathologic specimens for accurate histopathologic diagnosis and potentially curative treatment of early adenocarcinoma without resorting to major surgical resection. The safety and efficacy of the technique, which was pioneered in the upper gastrointestinal tract, has been established by the consistently impressive outcomes from expert centers in Japan and some other eastern countries. However, ESD is challenging to perform in the colorectum and there is a significant risk of complications, particularly in the early stages of the learning curve. Early studies from western centers raised concerns about the high complication rates, and the impressive results from Japanese centers were not replicated. As a result, many western endoscopists are skeptical about the role of ESD and few centers have incorporated the technique into their practice. Nevertheless, although the distribution of expertise, referral centers and modes of practice may differ in Japan and western countries, ESD has an important role and can be safely and effectively incorporated into western practice. Key to achieving this is meticulous lesion assessment and selection, appropriate referral to centers with the necessary expertise and experience and application of the appropriate technique individualized to the patient. This review discusses the advantages, risks and benefits of ESD to treat colorectal lesions and the importance of preprocedure lesion assessment and in vivo diagnosis and outlines a pragmatic rationale for appropriate lesion selection as well as the patient, technical and institutional factors that should be considered.

show abstract

Effect of prior biopsy sampling, tattoo placement, and snare sampling on endoscopic resection of large nonpedunculated colorectal lesions

Cited by 63 publications

References 27 publications

Look, but don’t touch: what not to do in managing large colorectal polyps

Look, but don’t touch: what not to do in managing large colorectal polyps

Endoscopic mucosal resection and endoscopic submucosal dissection of large colonic polyps

Colorectal endoscopic submucosal dissection: patient selection and special considerations

Contact Info

Product

Resources

About