Objective: The aim of this study was to evaluate the safety and efficacy of endoscopic submucosal dissection (ESD) of colonic polyps larger than 20 mm.
Material And Methods: Between March 2017 and July 2019, a gastro-entero endoscopist team resected 24 large colorectal polyps measuring 20-35 mm in diameter using the ESD technique. After the injection of a mixture of hydroxypropyl methylcellulose with dilute epinephrine and methylene blue into the submucosal layer, a circumferential incision was performed using an electrosurgical knife.
Results: A total of 24 colorectal polyps (≥20 mm) from 20 patients were evaluated. The mean age of the patients was 60 years; 16 patients were men and 4 patients were women. The mean polyp size removed by colorectal ESD was 35.3 mm (range 20.0-70.1 mm), and all 24 polyps were larger than 2 cm (100%). There were no cases of delayed bleeding after the colorectal ESD nor were there any post-surgery complications.
Conclusion: This study demonstrates the efficacy and safety of carrying out ESD of large polyps. This is important because there is not a large body of literature on this subject in this specific population.
Key Words: Colonic polyps, Endoscopic submucosal dissection, Gastrointestinal endoscopy.
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Surg Endosc
January 2025
Department of Internal Medicine, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, Taiwan.
Background: This study aimed to investigate the clinical characteristics and esophageal motility of patients with gastric cardia submucosal tumors (SMTs) and the associated changes after endoscopic resection based on high-resolution impedance manometry (HRIM).
Methods: From our electronic database, we identified patients who underwent pre-operative evaluation of gastric cardia SMTs between 2015 and 2023. All patients completed standardized symptom questionnaires and underwent endoscopic ultrasonography and HRIM.
Gastro Hep Adv
July 2024
Departments of Pathology, National Hospital Organization Hakodate National Hospital, Hakodate, Hokkaido, Japan.
Gastro Hep Adv
October 2024
Division of Gastroenterology, Kingston Health Sciences Centre, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada.
Most gastric neoplastic lesions appear in patients with gastric premalignant conditions. Here, we present the case of a 75-year-old woman with no prior history of infection, with a big gastric adenoma resected by endoscopic submucosal dissection. Histopathological examination revealed high-grade foveolar dysplasia.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Department of Surgery, The University of Hong Kong, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China. Electronic address:
Introduction: Endoscopic resection is suitable for most benign gastric or early stage cancerous polyps. Laparoscopic local resection is performed only for gastric polyps that are difficult to treat with endoscopic resection, such as recurrent or large polyps. However, when polyps are located in difficult regions, such as the gastric cardia and prepyloric antrum, wedge resection may damage the sphincter around the cardia or pylorus, resulting in postoperative deformity or stenosis.
View Article and Find Full Text PDFJ Clin Med
January 2025
Gastroenterology and Hepatology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
: Endoscopic resection with lift polypectomy using submucosal injection (SI) for large non-pedunculated colorectal polyps is recommended to facilitate complete mucosal resection and decrease the risk of perforation; however, there are no studies comparing the safety and efficacy of large polypectomies with and without lift polypectomy. We aimed to evaluate the feasibility and safety of the polypectomy technique without SI compared to the routine use of SI. : We performed a single tertiary center retrospective study evaluating all consecutive large non-pedunculated colorectal polyps (≥20 mm) referred to expert endoscopists in polypectomy from 2018 through 2021.
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