Case Report
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Underwater Endoscopic Mucosal Resection without Submucosal Injection Facilitates En bloc Resection of Colon Adenomas Extending into a Diverticulum
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Yoshikazu Hayashi, Masahiro Okada, Takaaki Morikawa, Tatsuma Nomura, Hisashi Fukuda, Takahito Takezawa, Alan Kawarai Lefor, Hironori Yamamoto
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Clin Endosc 2021;54(3):436-440. Published online November 6, 2020
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DOI: https://doi.org/10.5946/ce.2020.168
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Abstract
PDFSupplementary MaterialPubReaderePub
- 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.
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Yoji Takeuchi, Satoki Shichijo, Noriya Uedo, Ryu Ishihara
DEN Open.2022;[Epub] CrossRef
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Focused Review Series: Endoscopic Submucosal Dissection for Colorectal Tumors
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Advanced Treatment and Imaging in Colonoscopy: The Pocket-Creation Method for Complete Resection and Linked Color Imaging for Better Detection of Early Neoplastic Lesions by Colonoscopy
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Hironori Yamamoto, Satoshi Shinozaki, Yoshikazu Hayashi, Yoshimasa Miura, Tsevelnorov Khurelbaatar, Hiroyuki Osawa, Alan Kawarai Lefor
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Clin Endosc 2019;52(2):107-113. Published online January 10, 2019
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DOI: https://doi.org/10.5946/ce.2018.189
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Abstract
PDFPubReaderePub
- Early detection and resection of neoplastic lesions are key objectives to diminish colorectal cancer mortality. Resection of superficial colorectal neoplasms, cold snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection have all been developed and used worldwide. The pocket-creation method facilitates the resection of tumors in difficult and routine locations. Early detection is the most important first step to maximize the benefits of recent advancements in endoscopic techniques. However, the detection of small, flat-shaped, or faded color lesions remains difficult. Linked color imaging, a novel multi-light technology, facilitates the recognition of minor differences in tissue by enhancing the color contrast between early colorectal neoplasms and surrounding normal mucosa in a bright field of view. The most striking feature of linked color imaging is its ability to display the color of early neoplastic lesions as distinct from inflammatory changes, both of which have similar “redness” when viewed using white light imaging. To increase the detection rate of neoplasms, linked color imaging should be used from the outset for endoscopic observation. Early detection of superficial colorectal tumors can result in decreased mortality from colorectal cancer and maintain a good quality of life for patients.
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Brief Report
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Laterally Spreading Tumor of the Rectum Delineated with Linked Color Imaging Technology
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Masahiro Okada, Hirotsugu Sakamoto, Takahito Takezawa, Yoshikazu Hayashi, Keijiro Sunada, Alan K. Lefor, Hironori Yamamoto
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Clin Endosc 2016;49(2):207-208. Published online February 12, 2016
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