EMR and ESD: Indications, techniques and results

Rashid, Mamoon Ur; Alomari, Mohammad; Afraz, Sadaf; Erim, Tolga

doi:10.1016/j.suronc.2022.101742

Cited by 17 publications

(6 citation statements)

References 63 publications

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“…121 Intraprocedural bleeding may happen particularly in rectal lesions but can be easily managed using coagulation Open access current delivered through the ESD knife or haemostatic forceps in case of significant bleeding. 122 Kobayashi et al also reported that post-ESD immediate and delayed bleedings occurred in 4.5% and 1.3% of patients, respectively, but could be successfully managed endoscopically. Another uncommon adverse outcome is perforation, which is mostly managed non-surgically during the colonoscopy using clip closure.…”

Section: Technical Success Of Standard Esd and Associated Adverse Eventsmentioning

confidence: 98%

Endoscopic resection of large non-pedunculated colorectal polyps: current standards of treatment

Taghiakbari,

Kim,

Djinbachian

et al. 2024

egastro

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Colorectal cancer is a significant public health concern, and large non-pedunculated colorectal polyps pose a substantial risk for malignancy and incomplete resection, which may lead to interval cancer. The choice of resection technique is influenced by various factors, including polyp size, morphology, location, submucosal invasion depth and endoscopist expertise. For non-cancerous superficial large non-pedunculated polyps, conventional hot or cold snare polypectomy, endoscopic mucosal resection and endoscopic submucosal dissection are common techniques for non-surgical therapeutic endoscopic resection of these polyps. This manuscript provides a comprehensive review of literature on current endoscopic resection techniques for large non-pedunculated colorectal polyps, emphasising indications, advantages, limitations and outcomes.

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Section: Technical Success Of Standard Esd and Associated Adverse Eventsmentioning

confidence: 98%

Endoscopic resection of large non-pedunculated colorectal polyps: current standards of treatment

Taghiakbari,

Kim,

Djinbachian

et al. 2024

egastro

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“…With the development of minimally invasive endoscopic techniques, the widespread adoption of curative R0 resection for early GIT cancer has replaced invasive surgical approaches 3 . However, intraoperative or delayed perforations during procedures require endoscopists to have immediate management devices and skills.…”

Section: Introductionmentioning

confidence: 99%

Application of natural orifice transluminal endoscopic surgery with ENDOCRAB system for stomach perforation model: ex vivo porcine study

Jeon,

Hwang,

Lee

et al. 2024

Sci Rep

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Iatrogenic stomach perforation is a detrimental, irreversible, and fatal condition. Traditional surgery and endoscopic suturing clips and devices have been introduced to seal holes and prevent sepsis and disease progression. However, the development of endoscopic devices for perforations remains challenging, with no standard device available. This study investigates the superficial layer approximation strengths of the newly designed ENDOCRAB system for gastric wall defects. Thirty porcine stomachs were prepared ex vivo for the perforation model and distributed equally into three groups: ENDOCRAB system, Through-the-Scope Clip (TTSC), and hand suturing (HS). Both ENDOCRAB and TTSC achieved mucosal–submucosal layer apposition, whereas HS allowed a full-thickness layer. Their air leakage pressure and procedural duration were measured. The analysis of air-leakage pressure demonstrated comparable suture strength between ENDOCRAB (118.5 ± 41.7 mmHg) and HS (127.4 ± 30.2 mmHg, P = 0.812), but inferior strength with TTSC (73.6 ± 21.6 mmHg, P = 0.012). HS achieved the shortest procedural duration, whereas ENDOCRAB and TTSC showed no significant differences. The ENDOCRAB system showed significantly greater strength than the TTSC, was comparable to HS in strength, and required a procedural duration similar to that of the TTSC. Furthermore, long-term in vivo experiments and histological evaluations are essential.

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“…The submucosal buffer created through this process effectively prevents deeper thermal damage, thereby ensuring a high level of safety. [ 5 ] This approach has been shown to yield favorable efficacy. [ 6 ] As an illustration, Chaoui et al [ 7 ] conducted a study on EMR for colorectal polyps, which revealed a 95.2% complete resection rate and high success rate.…”

Section: Introductionmentioning

confidence: 99%

Comparing efficacy and factors of postoperative bleeding in endoscopic mucosal resection vs coagulation for intestinal polyps

Li,

Yu,

Wang

et al. 2023

Medicine

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This study aimed to assess the effectiveness of Endoscopic Mucosal Resection (EMR) and Argon Plasma Coagulation (APC) as therapeutic approaches for intestinal polyps in patients, and to examine the factors associated with postoperative bleeding. This study included 132 patients diagnosed with colorectal polyps (188 polyps) who underwent endoscopic surgery at our hospital between January 2022 and December 2022. Based on the surgical method employed, the patients were divided into 2 groups: EMR (68 cases, 97 polyps) and APC (64 cases, 91 polyps). Comparative analyses were conducted to assess the clinical efficacy, surgery-related indicators, and quality of life the 2 groups. Furthermore, an investigation was carried out to identify the factors associated with postoperative bleeding. The analysis revealed no statistically significant difference in the cure rate of flat and superficial raised polyps between the EMR group and the APC (P > .05). However, it was found that the EMR group exhibited a significantly higher cure rate for subpedunculated and raised-pedunculated polyps compared to the APC group (P < .05). The results of logistics analysis showed that patients with hypertension (OR = 2.876, 95% CI: 1.119–7.393), patients with diabetes (OR = 5.278, 95% CI: 1.388–20.064), patients with hyperlipidemia (OR = 2.594, 95% CI: 1.054–6.380), the polyps of right hemicolon (OR = 2.743, 95% CI: 1.003–7.504), rectal polyps (OR = 5.143, 95% CI: 1.728–7.504), pedunculated polyps (OR = 4.758, 95% CI: 1.322–17.129), adenomatous polyps (OR = 3.152, 95% CI: 1.018–9.757) were independent risk factors for postoperative bleeding in patients with colorectal polyps (P < .05). The findings suggest that for subpedunculated and pedunculated-raised polyps, EMR can be a suitable treatment approach. On the other hand, flat and superficial-raised polyps can be effectively managed with either EMR or APC. The presence of hypertension, diabetes, hyperlipidemia, polyps of the right hemicolon, rectal polyps, pedunculated polyps, and adenomatous polyps has been established as independent risk factors for postoperative bleeding in patients with colorectal polyps.

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EMR and ESD: Indications, techniques and results

Cited by 17 publications

References 63 publications

Endoscopic resection of large non-pedunculated colorectal polyps: current standards of treatment

Endoscopic resection of large non-pedunculated colorectal polyps: current standards of treatment

Application of natural orifice transluminal endoscopic surgery with ENDOCRAB system for stomach perforation model: ex vivo porcine study

Comparing efficacy and factors of postoperative bleeding in endoscopic mucosal resection vs coagulation for intestinal polyps

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