Volume 3, Issue 12, Pages (December 2018)

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Presentation transcript:

Volume 3, Issue 12, Pages 378-380 (December 2018) Precutting EMR with full or partial circumferential incision with a snare tip for the en bloc resection of difficult colorectal lesions Naohisa Yoshida, MD, PhD, Ken Inoue, MD, PhD, Osamu Dohi, MD, PhD, Yoshito Itoh, MD, PhD VideoGIE Volume 3, Issue 12, Pages 378-380 (December 2018) DOI: 10.1016/j.vgie.2018.09.014 Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Precutting EMR with partial incision for a depressed lesion. A, 10-mm IIa+IIc lesion on the sigmoid colon. B, Narrow-band imaging magnification showed an irregular pattern but no destruction. The lesion was diagnosed as high-grade dysplasia (orig. mag. × 50). C, Depressed center of submucosal elevation after the injection. D, Partial circumferential incision of the mucosa on the oral side of the tumor made with a snare tip. E, F, Snaring was performed, and the tumor was resected en bloc. The total procedure time was 5 minutes. G, H, Histologic examination showed high-grade dysplasia with a negative margin, diagnosed as intramucosal cancer in Japan (H&E, orig. mag. ×2.5 and ×10). VideoGIE 2018 3, 378-380DOI: (10.1016/j.vgie.2018.09.014) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Precutting EMR with a full incision for a large lesion. A, 25-mm IIa lesion on the ascending colon. B, Blue laser imaging magnification showed dilated crypts, which was consistent with a sessile serrated polyp. C, Injection of 0.13% hyaluronic acid was performed, and good elevation was achieved; however, the lesion was too large for regular EMR. D, Full circumferential incision was performed with a snare tip. E, F, The lesion was resected en bloc with a snare, and later histologic examination revealed a sessile serrated polyp with a negative margin (not shown). VideoGIE 2018 3, 378-380DOI: (10.1016/j.vgie.2018.09.014) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions