Superficial colonic neoplasms sometimes extend into a diverticulum. Conventional endoscopic mucosal resection of these lesions is considered challenging because colonic diverticula do not have a muscularis propria and are deeply inverted. Even if the solution is carefully injected below the mucosa at the bottom of the diverticulum, the mucosa is rarely elevated from the diverticular orifice, and it is usually just narrowed. Although endoscopic submucosal dissection or full-thickness resection with an over-the-scope clip device enables the complete resection of these lesions, it is still challenging, time consuming and expensive. Underwater endoscopic mucosal resection without submucosal injection (UEMR) is an innovative technique enabling en bloc resection of superficial colon lesions. We report three patients with colon adenomas extending into a diverticulum treated with successful UEMR. UEMR enabled rapid and safe en bloc resection of colon lesions extending into a diverticulum.
Citations
Citations to this article as recorded by
Underwater endoscopic mucosal resection for colorectal lesions: Can it be an “Underwater” revolution? Yoji Takeuchi, Satoki Shichijo, Noriya Uedo, Ryu Ishihara DEN Open.2022;[Epub] CrossRef
A 62-year-old man with a flat early esophageal cancer was referred for endoscopic treatment. White light imaging revealed a pale red lesion, whereas linked color imaging (LCI) and blue laser imaging (BLI) yielded purple and brown images, respectively. Iodine staining demonstrated a large unstained area with a homogenous but very weak pink-color sign. This area appeared more clearly as purple and green on LCI and BLI, respectively; however, a different colored portion was observed at the 4 o’clock position inside the iodineunstained area. Histopathology findings of the resected specimen revealed squamous intraepithelial neoplasia at the 4 o’clock position and an esophageal squamous cell carcinoma in the remaining iodine-unstained area. LCI and BLI combined with iodine staining produce characteristic images that overcomes the pink-color sign, reflecting the histological features of a flat esophageal neoplasm. This new method is useful for detailed evaluation of early flat squamous cell neoplasms.
Citations
Citations to this article as recorded by
Linked color imaging vs Lugol chromoendoscopy for esophageal squamous cell cancer and precancerous lesion screening: A noninferiority study Zi-Xin Wang, Long-Song Li, Song Su, Jin-Ping Li, Bo Zhang, Nan-Jun Wang, Sheng-Zhen Liu, Sha-Sha Wang, Shuai Zhang, Ya-Wei Bi, Fei Gao, Qun Shao, Ning Xu, Bo-Zong Shao, Yi Yao, Fang Liu, En-Qiang Linghu, Ning-Li Chai World Journal of Gastroenterology.2023; 29(12): 1899. CrossRef
Usefulness of linked color imaging in the early detection of superficial esophageal squamous cell carcinomas Koki Nakamura, Yuji Urabe, Shiro Oka, Naoko Nagasaki, Naoki Yorita, Kosaku Hata, Kazuhiko Masuda, Mio Kurihara, Takahiro Kotachi, Tomoyuki Boda, Shinji Tanaka, Kazuaki Chayama Esophagus.2021; 18(1): 118. CrossRef
Inter‐observer variability of experts and trainees for the diagnosis of reflux esophagitis: Comparison of linked color imaging, blue laser imaging, and white light imaging Sang Pyo Lee, Sea Hyub Kae, Hyun Joo Jang, Dong Hee Koh, Eun Suk Jung Journal of Digestive Diseases.2021; 22(7): 425. CrossRef