Endoscopic Resection Techniques

Hoffman, Arthur; Heesen, Maximilian von; Kollmar, Otto; Kießlich, Ralf

doi:10.1159/000477923

Cited by 3 publications

(1 citation statement)

References 80 publications

(97 reference statements)

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“…Another limitations of EFTR, but also for EMR and ESD, are lesions in anatomically difficult locations. A new technique of combined endoscopic and laparoscopic surgery could be helpful in these cases 21. Conversion to standard surgical resection would be possible in case of inability to resect the entire lesion endoscopically.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous endoscopic full-thickness resection of two synchronous colonic granular cell tumours

et al. 2018

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Granular cell tumours (GCTs) are rare soft tissue tumours originating from Schwann cells. Due to potential malignant transformation, complete endoscopic resection should be aimed for. We report on a 49-year-old patient with two synchronous GCTs found in the caecum and the ascending colon, respectively. Synchronous endoscopic full-thickness resection (EFTR) using an all-in-one full-thickness resection device (FTRD) was performed under propofol sedation. Completeness of resection was proven histologically. No adverse events occurred. We report safe and complete simultaneous EFTR of two synchronous colonic GCTs.

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Section: Discussionmentioning

confidence: 99%

Simultaneous endoscopic full-thickness resection of two synchronous colonic granular cell tumours

et al. 2018

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Novel treatment for gastric intestinal metaplasia, a precursor to cancer

Lam

Lau

2020

JGH Open

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Background and Aim Gastric intestinal metaplasia (GIM) is precancerous with a worldwide prevalence of 25%. Eradicating H elicobacter pylori prevented about half of gastric cancers; failure to prevent the rest was attributed to GIM. GIM is irreversible and often extensive. There is no treatment. Existing endoscopic mucosal resection (EMR) is designed to treat early gastric cancer of usually <2 cm. We designed a two ‐endoscope technique of EMR for extensive lesions such as GIM. Methods Forty patients with histologically confirmed moderate to severe GIM (operative link on GIM [OLGIM] classification) received the treatment in a daycare center. Chromoendoscopy with methylene blue was first performed to indicate the GIM. Submucosal saline injections were used to lift the stained mucosa to form multiple safety cushions, which were transformed into artificial polyps by suction and ligation, using a cap familiar to gastroenterologists for ligation of esophageal varices. EMRs were then achieved by snare polypectomy. By rotating two gastroscopes, one was designated to perform lift and snare and the other to perform suction and ligation; cycles of lift–ligate–snare were performed until all stained mucosa was removed. Assessment chromoendoscopy with ≥seven biopsies was performed at 6 months. Results A total of 227 EMRs were performed, with a median of 3.5 per patient. Bleeding was uncommon and minimal. Gastric perforation ascribable to loss of a safety cushion occurred in one patient. Chromoendoscopy at 6 months in 36 willing patients showed no recurrence of GIM. Conclusion The two‐endoscope technique of EMR for GIM was essentially safe and effective, with no recurrence at 6 months. It could be performed by endoscopists with standard skills.

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