Underwater endoscopic mucosal resection after endoscopic ultrasound examination for safe and reliable complete resection of a deeply invasive submucosal cecal cancer

Abstract

▶ Fig. 2 Endoscopic ultrasound using a 20-MHz miniature probe showing: a a high echoic submucosal layer between the tumor and the muscularis during insufflation; b when the cecum contracted while still under water, the muscularis becoming circumferentially recessed and the submucosa becoming thicker, with the tumor appearing to float on the submucosa. c On underwater endoscopic view, the tumor was transformed from a sessile tumor to a floating subpedunculated tumor.

Underwater endoscopic mucosal resection of colon hemangiomas compatible with the blue rubber bleb nevus syndrome, following endoscopic ultrasonography

“…UEMR is usually simpler, cheaper, and more reliable than other conventional endoscopic resection techniques. When endoscopic ultrasonography (EUS) is performed prior to UEMR, EUS can allow prediction of the safety and reliability of UEMR because lesion characteristics such as depth, blood vessels, and echodensity are evaluated 4 . We illustrate a case in which colon hemangiomas compatible with BRBNS were resected endoscopically using UEMR.…”