Endoscopic mucosal resection and snare polypectomy for treatment of a colorectal polypoid adenoma in a dog

2014 ◽  
Vol 244 (12) ◽  
pp. 1435-1440 ◽  
Author(s):  
Kristin A. Coleman ◽  
Allyson C. Berent ◽  
Chick W. Weisse
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Mucosal Resection ◽  
Snare Polypectomy

scholarly journals Surveillance in Peutz-Jeghers syndrome: a case report

2017 ◽  
Vol 4 (3) ◽  
pp. 854 ◽  
Author(s):  
Sabarinathan Ramanathan ◽  
Pugazhendhi Thangavel ◽  
Ratnakar Kini ◽  
Kani Shaikh Mohamed ◽  
Premkumar Karunakaran ◽  
...  
Keyword(s):  
Case Report ◽  
Endoscopic Mucosal Resection ◽  
Male Patient ◽  
Right Hemicolectomy ◽  
Mucosal Resection ◽  
Peutz Jeghers Syndrome ◽  
Surveillance Endoscopy ◽  
Upper Gastrointestinal ◽  
Snare Polypectomy

Study performed surveillance endoscopy in a 23-year-old male patient with Peutz-Jeghers syndrome (PJS) who underwent right hemicolectomy with ileo-colic anastamosis for ileo-colic intussusception three years back. On evaluation, he found to have multiple upper gastrointestinal and ileal polyps. Subsequently he underwent polypectomies in three sessions by combined standard snare polypectomy and endoscopic mucosal resection (EMR) method without any complication. We present a case report that emphasizes the importance of surveillance and the role of prophylactic polypectomy in patients with PJS.

Cold versus hot endoscopic mucosal resection for nonpedunculated colorectal polyps sized 6–10 mm: a randomized trial

Endoscopy ◽  
2017 ◽  
Vol 50 (04) ◽  
pp. 403-411 ◽  
Author(s):  
Vasilios Papastergiou ◽  
Konstantina Paraskeva ◽  
Maria Fragaki ◽  
Ioannis Dimas ◽  
Emmanouil Vardas ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Saline Solution ◽  
Colorectal Polyps ◽  
Incomplete Resection ◽  
Established Method ◽  
Mucosal Resection ◽  
Cold Snare Polypectomy ◽  
Clinically Significant ◽  
Noninferiority Margin ◽  
Snare Polypectomy

Abstract Background and study aims Cold snare polypectomy is an established method for the resection of small colorectal polyps; however, significant incomplete resection rates still leave room for improvement. We aimed to assess the efficacy of cold snare endoscopic mucosal resection (CS-EMR), compared with hot snare endoscopic mucosal resection (HS-EMR), for nonpedunculated polyps sized 6 – 10 mm. Patients and methods This study was a dual-center, randomized, noninferiority trial. Consecutive adult patients with at least one nonpedunculated polyp sized 6 – 10 mm were enrolled. Eligible polyps were randomized (1:1) to be treated with either CS-EMR or HS-EMR. Both methods involved submucosal injection of a methylene blue-tinted normal saline solution. The primary noninferiority end point was histological eradication evaluated by postpolypectomy biopsies (noninferiority margin – 10 %). Secondary outcomes included occurrence of intraprocedural bleeding, clinically significant postprocedural bleeding, and perforation. Results Among 689 patients screened, 155 patients with 164 eligible polyps were included (CS-EMR n = 83, HS-EMR n = 81). The overall rate of histological complete resection was 92.8 % in the CS-EMR group and 96.3 % in the HS-EMR group (difference 3.5 %; 95 % confidence interval [CI] – 4.15 to 11.56), showing noninferiority of CS-EMR compared with HS-EMR. CS-EMR was shown to be noninferior both for polyps measuring 6 – 7 mm (CS-EMR 93.3 %; HS-EMR 100 %; 95 %CI – 7.95 to 21.3) and those of 8 – 10 mm (92.5 % vs. 94.7 %, respectively; 95 %CI – 7.91 to 13.16). Rates of intraprocedural bleeding were similar between the two groups (CS-EMR 3.6 %, HS-EMR 1.2 %; P  = 0.30). No clinically significant postprocedural bleeding or perforation occurred in either group. Conclusions CS-EMR appears to be a valuable modification of the standard cold snare technique, obviating the need to use diathermy for nonpedunculated colorectal polyps sized 6 – 10 mm.

Endoscopic Management of Polyps and Early Malignancy

2017 ◽  
Author(s):  
Nadim Mahmud ◽  
Tyler Berzin
Keyword(s):  
Gastrointestinal Tract ◽  
Endoscopic Submucosal Dissection ◽  
Endoscopic Mucosal Resection ◽  
Gastrointestinal Endoscopy ◽  
Critical Role ◽  
Endoscopic Management ◽  
Mucosal Resection ◽  
Submucosal Dissection ◽  
Polypectomy Snare ◽  
Snare Polypectomy

Gastrointestinal endoscopy plays a critical role in the detection, diagnosis, and management of premalignant and malignant conditions. Because of the diversity of polypoid and nonpolypoid abnormalities that may be encountered throughout the gastrointestinal tract, the modern endoscopist must be keenly aware of the differential diagnosis of these lesions, the appropriateness of biopsy or resection, and the subsequent management based on pathology or staging information. A variety of tissue sampling and resection techniques have been developed for this purpose, including forceps biopsy, snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection. Depending on the lesion encountered, these techniques may be both diagnostic and therapeutic. Here we review the endoscopic management of premalignant polyps and early malignancy that may be encountered at different locations in the gastrointestinal tract.  This review contains 17 figures, 5 tables and 47 references Key words: ablation, adenocarcinoma, adenoma, Barrett esophagus, biopsy, endoscopic mucosal resection, endoscopic submucosal dissection, forceps, polypectomy, snare

scholarly journals Safety and efficacy of band ligation and auto-amputation as adjunct to EMR of colonic large laterally spreading tumors, and polyps not amenable to routine polypectomy

2021 ◽  
Vol 14 ◽  
pp. 263177452110017
Author(s):  
Stephanie Romutis ◽  
Bassem Matta ◽  
Jonathan Ibinson ◽  
John Hileman ◽  
Smiljana Istvanic ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Complete Removal ◽  
Rubber Band ◽  
Polyposis Syndrome ◽  
Band Ligation ◽  
Mucosal Resection ◽  
Polyp Tissue ◽  
Snare Polypectomy ◽  
Laterally Spreading Tumors

Introduction: The safety and efficacy of colonic band ligation and auto-amputation (1) as adjunct to endoscopic mucosal resection of large laterally spreading tumors and (2) for polyps not amenable to routine polypectomy due to polyp burden or difficult location remain unknown. Methods: An institutional review board–approved retrospective single-institution study was undertaken of patients undergoing colonic band ligation and auto-amputation from 2014 to date. Patients with indications of ‘endoscopic mucosal resection for laterally spreading tumors’ and ‘polyp not amenable to snare polypectomy’ were included in the study. Data were collected on patient demographics, colonoscopy details (laterally spreading tumors/polyp characteristics, therapies applied, complications), pathology results, and follow-up (polyp eradication based on endoscopic appearance and biopsy results). Results: Patients undergoing endoscopic mucosal resection for laterally spreading tumors: Thirty-two patients (31 males, aged 68 ± 9.17 years) underwent endoscopic mucosal resection-band ligation and auto-amputation of 34 laterally spreading tumors (40 ± 10.9 mm). A median of 2 ± 1.09 bands were placed. Follow-up colonoscopy and biopsy results confirmed complete eradication in 21 laterally spreading tumors (70%). Nine (30%) laterally spreading tumors required additional endoscopic therapy to achieve complete eradication. Four (13%) patients underwent surgery for cancer, and two of them had resection specimens negative for cancer or residual adenoma. One patient suffered post-polypectomy syndrome. Patients undergoing band ligation and auto-amputation for polyps not amenable to snare polypectomy: Seven patients underwent band ligation and auto-amputation due to serrated polyposis syndrome (one patient) and innumerable polyps, or polyps in difficult locations (extension into diverticula: two patients; terminal ileum: two patients; appendiceal orifice: one patient; anal canal: one patient). The patient with serrated polyposis syndrome achieved dramatic decrease in polyp burden, but not eradication. Follow-up in five of the six remaining patients documented polyp eradication. The patient with serrated polyposis syndrome suffered from rectal pain and tenesmus following placement of 18 bands. Conclusions: Band ligation and auto-amputation in the colon may be a safe and effective adjunct to current endoscopic mucosal resection and polypectomy methods and warrants further study. Plain Language Summary Colonoscopy with rubber band placement to aid in complete removal of large polyps and polyps in technically challenging locations Colonoscopy is a commonly performed procedure for the early detection of colon and rectal cancer, and prevention through polyp removal.During colonoscopy, sometimes situations are encountered making polyp removal difficult. These can include the presence of larger polyps or the location of a polyp in an area that makes removal technically challenging or high risk.A particularly challenging situation arises when after extensive effort there is still polyp tissue remaining that cannot be removed using routine techniques. We are interested in exploring a technique which involves the placement of a rubber band after sucking a small area of the colon lining into a cap loaded onto the tip of the colonoscope. With time the rubber band strangulates the tissue and falls off along with captured tissue and passes out of the colon naturally.To assess the effectives of this technique we studied patients that have undergone this procedure at our GI unit. We identified 32 patients with 34 large polyps between 4cm to 6cm that we placed rubber bands on polyp tissue after we were unable to completely remove the polyp. On their follow up colonoscopy, complete polyp removal was successful in 21 polyps. We were also able to achieve complete polyp removal in 9 of the remaining large polyps after additional treatment. Four patients underwent surgery because cancer was found in analysis of polyp tissue.In 5 of 6 patients with polyps in difficult locations (e.g. partly within the lumen of the appendix), placement of a rubber band led to complete removal of polyp tissue.Two patients in our study population had mild adverse events that were managed with simple measures.We believe our results show promise for our described technique and this technique should be tested in larger studies.

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