Endoscopic resection of gastrointestinal lipomas: a single-center experience

Lee, Kwang Jae; Kim, Gwang Ha; Park, Do Youn; Shin, Namsoo; Lee, Bong Eun; Ryu, Dong Yup; Kim, Dong Uk; Song, Geun Am

doi:10.1007/s00464-013-3151-9

Cited by 64 publications

(90 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…ERs are reported to be useful in the treatment of various benign and malignant duodenal lesions, including intramucosal adenocarcinomas, adenomas, lipomas and neuroendocrine tumors (20,(36)(37)(38)(39). The required specific technique (e.g.…”

Section: Discussionmentioning

confidence: 99%

Pathologic evaluation of endoscopically resected non-ampullary duodenal lesions: a single center experience

Taşkin¹,

Aslan²,

Mericoz³

et al. 2019

TJPATH

View full text Add to dashboard Cite

Objective: Endoscopic resections are increasingly being used for superficial gastrointestinal lesions. However, application of these techniques in the duodenum remains challenging, due to the technical difficulties and high complication rates. This study projects a western tertiary center's experience in the endoscopic treatment and diagnostic workup of 19 cases of non-ampullary duodenal lesions. Material and Method: Specimens (12 endoscopic mucosal resections, 6 endoscopic submucosal dissections, and one endoscopic full-thickness resection) were processed following a strict protocol (photographed, mapped digitally and submitted totally) for histopathologic examination. Clinicopathologic characteristics, margin status and follow-up information were analyzed. Results: The mean age of the 16 patients was 52 years (range: 22-81). Mean lesion size was 1.4 cm (range: 0.3-3.6 cm) for all cases, 2 cm for endoscopic submucosal dissections and 1.1 cm for endoscopic mucosal resections. Mean number of blocks submitted was 4/case. Seven neuroendocrine tumors, 3 tubulovillous adenomas were diagnosed along with nine benign lesions. For endoscopic submucosal dissections, en-bloc and R0 resection rates were 100% (n=6/6) and 83% (n=5/6); for endoscopic mucosal resections, they were 92% (n=11/12) and 83% (n=10/12), respectively. Only one patient had procedure-related late perforation that was managed endoscopically. No mortality was encountered. Conclusion: Duodenal endoscopic resections proved successful, safe and feasible methods in a tertiary center. The pathologist's role is to designate the accurate diagnosis, related histopathologic parameters and margin status. The gross protocol was found to be essential in evaluating specimen margins and orientation, as well as in size measurement. We recommend following a standardized approach including gross photography and digital mapping when handling these specimens, for both diagnostic and data collection purposes.

show abstract

Section: Discussionmentioning

confidence: 99%

Pathologic evaluation of endoscopically resected non-ampullary duodenal lesions: a single center experience

Taşkin¹,

Aslan²,

Mericoz³

et al. 2019

TJPATH

View full text Add to dashboard Cite

show abstract

“…The mucosa regenerated on the unroofed surface after 1 month in the 1st patient, whereas endoscopic findings showed that adipose tissue had not drained in the 2nd patient within 1 month, and additional endoscopic mucosal resection (EMR) was required. Unroofing resulting in incomplete resection that requires additional EMR has been reported [9]. More investigation is needed about lipomas treated by endoscopic unroofing, particularly those from which adipose tissue does not drain.…”

Section: Discussionmentioning

confidence: 99%

Two Patients with Large Colonic Lipomas for which Endoscopic Unroofing was Ineffective

Tomiki

Niwa

Nagayasu

et al. 2016

Case Rep Gastroenterol

View full text Add to dashboard Cite

Endoscopic unroofing is effective for treating large colonic lipomas. However, additional endoscopic resection is occasionally required when the outcomes of initial unroofing are incomplete. The colonoscopy of an 82-year-old woman with abdominal pain revealed a yellowish lipoma of about 20 mm in the transverse colon. The mass was treated by unroofing, but a follow-up colonoscopy 5 days later revealed residual lipoma. One month later, the regenerated surface had become covered with mucosa, and the status of the lipoma had returned to that before unroofing. The colonoscopy of a 74-year-old man with abdominal pain and melena revealed a 50-mm-wide protruding lipoma in the transverse colon. The mucosa of the upper third of the lipoma was excised using an electric knife and snare, which allowed the immediate partial drainage of adipose tissue. Unroofing proceeded, but 7 days later, the unroofed surface had become coated with a white substance, and the residual lipoma required additional endoscopic resection. Colonic lipomas are often asymptomatic. However, patients with abdominal pain and hemorrhage should be treated in consideration of complete resection, but not by unroofing, which could leave a residual tumor. Drainage should be confirmed after unroofing and any residual lipoma should be treated by additional resection.

show abstract

“…Characteristically, the ‘pillow sign’ is an endoscopic feature which refers to the indentation of colonic lipomas with biopsy forceps, aiding a clinical diagnosis . Colonoscopy can be therapeutic with descriptions of complete and partial resections previously published …”

mentioning

confidence: 99%

“…Direct endoscopic visualization allows for assessment of base broadness, size and degree of obstruction, and allows for biopsies to confirm the diagnosis and exclude malignancy. [5][6][7] Characteristically, the 'pillow sign' is an endoscopic feature which refers to the indentation of colonic lipomas with biopsy forceps, aiding a clinical diagnosis. 8 Colonoscopy can be therapeutic with descriptions of complete and partial resections previously published.…”

mentioning

confidence: 99%

“…6,7,9 After a review of English literature published through PubMed and Medline databases, to our knowledge, at 9 cm, this is the largest described lipoma that was completely resected endoscopically. [1][2][3][4][5][6][7]9 Partial endoscopic resection of colonic lipomas up to 8 cm using a snare and un-roofing technique has also been described. 9 This case highlights the potential for advanced endoscopic therapy in managing symptomatic giant colonic lipomas.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Colonoscopic resection of giant colonic lipoma causing subacute large bowel obstruction

Donovan

Abeyasundara

Nabi

2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

Endoscopic resection of gastrointestinal lipomas: a single-center experience

Abstract: Endoscopic treatment appears to be a safe and effective treatment for GI lipomas, including large lipomas (≥2 cm in diameter).

Cited by 64 publications

References 21 publications

Pathologic evaluation of endoscopically resected non-ampullary duodenal lesions: a single center experience

Pathologic evaluation of endoscopically resected non-ampullary duodenal lesions: a single center experience

Two Patients with Large Colonic Lipomas for which Endoscopic Unroofing was Ineffective

Colonoscopic resection of giant colonic lipoma causing subacute large bowel obstruction

Contact Info

Product

Resources

About