Endoscopic resection of large pedunculated colon polyps using only a scissor-type knife: a case series

Objective Endoscopic resection of sinonasal cancer has become an alternative to open craniofacial surgery and leads to safe and satisfying results in emerging numbers. Randomized study data comparing outcomes between approaches are missing. Hence, it remains unclear which subgroups of patients might profit most from each technique. We aimed to identify such patient and tumor characteristics and gather information for future prospective study design. Study Design Case series with chart review. Setting Tertiary academic center. Subjects and Methods This study is based on a retrospective chart review of 225 patients undergoing open craniofacial or endoscopic resection for sinonasal malignancy between 1993 and 2015 at Munich University Hospital. Statistical analyses include t test, chi-square, Kaplan-Meier charts, and univariate and multivariate analyses. Results The sample size was similar between the endoscopic and open surgery groups. Tumors were significantly larger in patients who underwent open craniofacial resection. The risk of notable bleeding ( P = .041) was lower and hospital stay shorter ( P = .001) for endoscopic interventions of all tumor stages. Rates of overall ( P = .024) and disease-specific ( P = .036) survival were significantly improved for endoscopic cases; improved recurrence-free survival rates did not achieve statistical significance ( P = .357). For cases matched for tumor size, this improvement was confirmed for T3 tumors ( P = .038). Regional and distant metastatic tumor spread generally worsened survival in both surgical subgroups. Multivariate Cox regression analysis revealed independent prognosticators for overall survival. Conclusion Endoscopic tumor resection remains a suitable option for distinct indications and showed improved outcome in intermediate-stage tumors in our collective. Further randomized studies acknowledging the here-identified factors are needed to improve future therapy guidelines and patient care.

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Valuing innovative endoscopic techniques: prophylactic clip closure after endoscopic resection of large colon polyps

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2020.01.018 ◽

2020 ◽

Vol 91 (6) ◽

pp. 1353-1360 ◽

Cited By ~ 1

Author(s):

Eric D. Shah ◽

Heiko Pohl ◽

Douglas K. Rex ◽

Michael B. Wallace ◽

Seth D. Crockett ◽

...

Keyword(s):

Endoscopic Resection ◽

Colon Polyps ◽

Endoscopic Techniques ◽

Clip Closure

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Role of Endoscopic Resection Versus Surgical Resection in Management of Malignant Colon Polyps: a National Cancer Database Analysis

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-019-04356-0 ◽

2019 ◽

Vol 24 (1) ◽

pp. 177-187 ◽

Cited By ~ 1

Author(s):

Dhruv Lowe ◽

Sheikh Saleem ◽

Muhammad Osman Arif ◽

Shreya Sinha ◽

Gary Brooks

Keyword(s):

Surgical Resection ◽

Endoscopic Resection ◽

Colon Polyps ◽

National Cancer Database ◽

Database Analysis

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Submucosal Tunnel Endoscopic Resection of Gastric Lesion Before Obesity Surgery: a Case Series

Obesity Surgery ◽

10.1007/s11695-020-04928-z ◽

2020 ◽

Vol 30 (11) ◽

pp. 4636-4642

Author(s):

Gianfranco Donatelli ◽

Fabrizio Cereatti ◽

Jean-Loup Dumont ◽

Nelson Trelles ◽

Panagiotis Lainas ◽

...

Keyword(s):

Obesity Surgery ◽

Endoscopic Resection ◽

Gastric Lesion ◽

Case Series ◽

Submucosal Tunnel ◽

Submucosal Tunnel Endoscopic Resection

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Salvage endoscopic resection in patients with esophageal adenocarcinoma after chemoradiotherapy

Endoscopy International Open ◽

10.1055/a-0599-6008 ◽

2018 ◽

Vol 06 (09) ◽

pp. E1126-E1129 ◽

Cited By ~ 1

Author(s):

Irma C. Noordzij ◽

Wouter L. Curvers ◽

Clément J. Huysentruyt ◽

Grard A.P. Nieuwenhuijzen ◽

Geert-Jan Creemers ◽

...

Keyword(s):

Esophageal Adenocarcinoma ◽

Endoscopic Resection ◽

Argon Plasma Coagulation ◽

Case Series ◽

Argon Plasma ◽

Residual Tumor ◽

Esophageal Resection ◽

Sustained Remission ◽

Long Term Prognosis

Abstract Background and study aims For early esophageal adenocarcinoma, endoscopic resection is an accepted curative treatment with an excellent long-term prognosis. Case series from Japan have reported endoscopic resection of residual esophageal squamous cell carcinoma after chemoradiotherapy. This is the first report describing endoscopic resection of residual esophageal adenocarcinoma after chemoradiotherapy. Two patients with advanced esophageal adenocarcinoma had been treated with chemoradiotherapy because comorbidity precluded esophageal resection. When residual tumor was observed endoscopically, complete remission was achieved by salvage endoscopic therapy alone or in combination with argon plasma coagulation (APC). Both patients achieved long-term sustained remission and died of non-tumor-related causes.

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Improved endoscopic resection of large flat lesions and early cancers using an external additional working channel (AWC): a case series

Endoscopy International Open ◽

10.1055/a-0824-6912 ◽

2019 ◽

Vol 07 (02) ◽

pp. E298-E301 ◽

Cited By ~ 5

Author(s):

Benjamin Walter ◽

Simone Schmidbaur ◽

Yannick Krieger ◽

Alexander Meining

Keyword(s):

Gastrointestinal Tract ◽

Endoscopic Resection ◽

Case Series ◽

En Bloc Resection ◽

Lower Gastrointestinal Tract ◽

En Bloc ◽

Dual Channel ◽

Arterial Bleeding ◽

Flat Lesions ◽

Bimanual Tasks

Abstract Background En-bloc resection of large, flat lesions or early stages of cancer is challenging. No bimanual tasks are possible using standard endoscopes. Dual-channel endoscopes are not available everywhere and have a small distance between the channels. Patients and methods A new external additional working channel (AWC) (Ovesco, Tuebingen, Germany) was designed and developed potentially enabling bimanual tasks. Fixed to the tip of a standard gastroscope or pediatric colonoscope, a second endoscopic tool can be inserted through the AWC and used for tissue retraction during endoscopic resection. Results In the upper and lower gastrointestinal tract, endoscopic mucosal resection (EMR) with a modified grasp-and-snare technique and endoscopic submucosal dissection (ESD) were performed successfully using the AWC in eight patients. Complications were acute arterial bleeding post-EMR in two cases treated by endoscopic clipping. Conclusions We conclude that a newly developed external additional working channel (AWC) enables endoscopic resection of large lesions in the upper and lower gastrointestinal tract. Potential benefits are its suitability for EMR and ESD, no need for a dual-channel endoscope and an adjustable distance of working channels.

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