scholarly journals Submucosal cavernous hemangioma of the esophagus. the rare clinical case of endoscopic diagnosis and treatment by the endoscopic submucosal dissection method (esd)

2019 ◽  
Vol 1 (7) ◽  
pp. 33-40
Author(s):  
V.A. Yakovenko ◽  
A.M. Kiosov ◽  
A.A. Denisenko ◽  
V.P. Kovalenko ◽  
S.V. Fen
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Cavernous Hemangioma ◽  
Clinical Case ◽  
Submucosal Tumor ◽  
Integrated Approach ◽  
University Hospital ◽  
Vascular Neoplasm ◽  
Submucosal Dissection ◽  
Endoscopic Method ◽  
Upper Third

The cavernous esophagus hemangiomais a rare, benign vascular neoplasm of the esophagus, which is asymptomatic and can be detected by chance during diagnostic video gastroscopy.The aim ofthe study is to describe in the rare clinical case of diagnosis and an integrated approach in choosing an endoscopic method of treating a submucosal benign vascular neoplasm of the esophagus (cavernous hemangioma).Material and method. A 46-year-old patient was sent to the University Hospital of ZSMU to conduct video esophagogastroduodenoscopy in order to examine and select the treatment method for the submucosaltumor of the upper third of the esophagus found in one of the city’s clinics.Results. A comprehensive examination of the patient with a submucosal neoplasm of the upper third of the esophagus, including video esophagogastroscopy with high-resolution endoscopes (EGD), endoscopic ultrasonography (EUS), and computer-aided tomography (CT) were performed. At the EGD a submucosal tumor was reviled in the upper third of the esophagus. It was bluish in color, had a wide base, 3cm in length and 2cm in height, movable, with soft-elastic consistency. EUS revealed that the tumor is not associated with the muscular layer, has many small vessels. The structure of the neoplasm was hypoechoic, inhomogeneous due to the inclusion of calcinates. On CT scan a rounded tumor was found in the lumen of the upper third of the esophagus, 20x15x30mm in size, with clear and even margins, homogeneous structure with a single calcinate in the structure was found. The patient was underwent of endoscopic surgery. The tumor was removed by the endoscopic submucosal dissection (ESD).Conclusion. Cavernous esophagus hemangioma is a rare vascular submucosal neoplasm of the esophagus, which is usually asymptomatic, but has a great potential for complications such as bleeding, which is sometimes fatal. Timely diagnosis and minimally invasive endoscopic treatment methods are the prevention of complications and the treatment of choice for the treatment of esophageal submucoustumors.

scholarly journals Advanced Colon Cancer after Curative Resection of Intramucosal Adenocarcinoma with Endoscopic Submucosal Dissection

2021 ◽  
pp. 603-609
Author(s):  
Akiko Sasaki ◽  
Chikamasa Ichita ◽  
Chihiro Sumida ◽  
Karen Kimura ◽  
Takashi Nishino ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Advanced Cancer ◽  
Curative Resection ◽  
Submucosal Tumor ◽  
R0 Resection ◽  
Surveillance Colonoscopy ◽  
Epithelial Tumor ◽  
Submucosal Dissection ◽  
Intramucosal Adenocarcinoma

Endoscopic resection, particularly endoscopic submucosal dissection (ESD), for colorectal cancers enables a precise pathological diagnosis and safe R0 resection. The recurrence rate after ESD is generally extremely low, with annual surveillance colonoscopy recommended. However, surveillance may not be considered for super-elderly patients owing to their condition. This is a case report of an 85-year-old man in whom curative resection was achieved for an intramucosal adenocarcinoma with ESD. The patient presented with a hypoechoic mass located in his lower right abdomen, diagnosed via surveillance abdominal ultrasound. He had undergone curative ESD for intramucosal cecal cancer 2 years prior. Colonoscopy revealed a type 2 epithelial tumor at the proximal aspect of the ESD scar. Ileocolic resection with lymph node dissection was performed. An epithelial tumor and well-differentiated adenocarcinoma but not a submucosal tumor was detected in the mucosal layer. The lesion was diagnosed not as a local recurrence after ESD but as a newly emerged original advanced cancer. After ESD for colorectal cancer, a newly developed advanced cancer may occur at the site of the ESD scar in a shorter term than usual. Surveillance colonoscopy after ESD is necessary even for super-elderly patients.

scholarly journals A Case of Gastric Cavernous Hemangioma Diagnosed by Endoscopic Submucosal Dissection

2013 ◽  
Vol 13 (3) ◽  
pp. 198
Author(s):  
Mun-Chul Kim ◽  
Shang Hoon Han ◽  
Mi Young Jang ◽  
Seol Bong Yoo ◽  
Back Jin Sung ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Cavernous Hemangioma ◽  
Submucosal Dissection

scholarly journals Safety and Efficacy of Nonanesthesiologist-Administrated Propofol during Endoscopic Submucosal Dissection of Gastric Epithelial Tumors

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Keiichiro Abe ◽  
Keiichi Tominaga ◽  
Akira Kanamori ◽  
Tsunehiro Suzuki ◽  
Hitoshi Kino ◽  
...  
Keyword(s):  
Adverse Events ◽  
Endoscopic Submucosal Dissection ◽  
University Hospital ◽  
Physical Status ◽  
Safety And Efficacy ◽  
Submucosal Dissection ◽  
Epithelial Tumors ◽  
Physical Status Classification ◽  
Significant Difference ◽  
Status Classification

Objective. There is no consensus regarding administration of propofol for performing endoscopic submucosal dissection (ESD) in patients with comorbidities. The aim of this study was to evaluate the safety and efficacy of propofol-induced sedation administered by nonanesthesiologists during ESD of gastric cancer in patients with comorbidities classified according to the American Society of Anesthesiologists (ASA) physical status. Methods. Five hundred and twenty-two patients who underwent ESD for gastric epithelial tumors under sedation by nonanesthesiologist-administrated propofol between April 2011 and October 2017 at Dokkyo Medical University Hospital were enrolled in this study. The patients were divided into 3 groups according to the ASA physical status classification. Hypotension, desaturation, and bradycardia were evaluated as the adverse events associated with propofol. The safety of sedation by nonanesthesiologist-administrated propofol was measured as the primary outcome. Results. The patients were classified according to the ASA physical status classification: 182 with no comorbidity (ASA 1), 273 with mild comorbidity (ASA 2), and 67 with severe comorbidity (ASA 3). The median age of the patients with ASA physical status of 2/3 was higher than the median age of those with ASA physical status of 1. There was no significant difference in tumor characteristics, total amount of propofol used, or ESD procedure time, among the 3 groups. Adverse events related to propofol in the 522 patients were as follows: hypotension (systolic blood pressure<90 mmHg) in 113 patients (21.6%), respiratory depression (SpO2<90%) in 265 patients (50.8%), and bradycardia (pulse rate<50 bpm) in 39 patients (7.47%). There was no significant difference in the incidences of adverse events among the 3 groups during induction, maintenance, or recovery. No severe adverse event was reported. ASA 3 patients had a significantly longer mean length of hospital stay (8 days for ASA 1, 9 days for ASA 2, and 9 days for ASA 3, P=0.003). However, the difference did not appear to be clinically significant. Conclusions. Sedation by nonanesthesiologist-administrated propofol during ESD is safe and effective, even for at-risk patients according to the ASA physical status classification.

scholarly journals Heterotopic Gastric Mucosa in Gastric Propria Muscularis Treated by Endoscopic Submucosal Dissection: A Case Report and Literature Review.

2021 ◽  
Author(s):  
Yuting Jia ◽  
Erfeng Li ◽  
Zhen Zhang ◽  
Bin Guo ◽  
Xing Chen
Keyword(s):  
Gastric Mucosa ◽  
Endoscopic Submucosal Dissection ◽  
Submucosal Tumor ◽  
Anatomical Variation ◽  
Abdominal Distension ◽  
Normal Mucosa ◽  
Heterotopic Gastric Mucosa ◽  
Upper Gastrointestinal Endoscopy ◽  
Submucosal Dissection ◽  
Mucosal Glands

Abstract Background: Heterotopic gastric mucosa（HGM）is a congenital anatomical variation. It can occur in various tissues and organs of the gastrointestinal tract. Part of the HGM appeared as a solitary, sessile submucosal lesions covered with normal mucosa, and because it was relatively rare, thereby resulting in some HGM to be easily missed or misdiagnosed. We report on a case of heterotopic gastric mucosa in gastric propria muscularis.Case presentation: A 32-year-old man with abdominal distension for one month. Upper gastrointestinal endoscopy revealed hemispherical lesion covered with smooth mucosa located in gastric antrum. Endoscopic ultrasound (EUS) revealed that it might be derived from the submucosa, with no echogenic nodules, and a partition is visible inside. Endoscopic submucosal dissection (ESD) was performed and histological examination revealed scattered heterotopic mucosal glands (HGG) located in the propria muscularis. Regular follow-up, the patient's abdominal distension was significantly relieved.Conclusion: HGM of the type of submucosal tumor-like lesion is rare. EUS is a well-established method for submucosal lesion. On EUS, these lesions showed cystic anechoic central core in the submucosa with no solid component,which is similar to gastric cyst. Therefore, this requires us to be alert to the possibility of HGM in order to further evaluate and treat, and if necessary, it can be removed by ESD.

scholarly journals Endoscopic Submucosal Dissection for Gastric Subepithelial Tumors: A Single-Center Experience

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Jin Sung Lee ◽  
Gwang Ha Kim ◽  
Do Youn Park ◽  
Jong Min Yoon ◽  
Tae Wook Kim ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Muscularis Propria ◽  
Complete Resection ◽  
Incomplete Resection ◽  
Efficacy And Safety ◽  
Muscularis Propria Layer ◽  
Submucosal Dissection ◽  
Upper Third ◽  
Subepithelial Tumors

Background and Aims. Endoscopic submucosal dissection (ESD) has been accepted as a treatment modality for gastrointestinal epithelial tumors. Recently, ESD has been applied to resect subepithelial tumors (SETs) in the gastrointestinal tract, but clinical evidence on its efficacy and safety is limited. The aim of this study was to investigate the efficacy and safety of ESD for gastric SETs and to assess possible predictive factors for incomplete resection. Patients and Methods. Between January 2006 and December 2013, a total of 49 patients with gastric SET underwent ESD at our hospital. Clinicopathologic characteristics of patients and SETs, therapeutic outcomes, complications, and follow-up outcomes were evaluated. Results. The overall rates of en bloc resection and complete resection were 88% (43/49) and 84% (43/49), respectively. Complete resection rates in tumors originating from the submucosal layer were significantly higher than those in tumors originating from the muscularis propria layer (90% versus 56%, P=0.028). In multivariate logistic regression analyses, tumor location (upper third: odds ratio [OR] 12.639, 95% confidence interval [CI] 1.087–146.996, P=0.043) and layer of tumor origin (muscularis propria: OR 8.174, 95% CI 1.059–63.091, P=0.044) were independently associated with incomplete resection. Procedure-related bleeding and perforation rates were both 4%. No recurrence was observed in patients with complete resection at a median follow-up period of 29 months (range: 7–83 months). Conclusions. ESD is an effective, safe, and feasible treatment for gastric SETs. The frequency of incomplete resection increases in tumors located in the upper third of the stomach and in those originating from the muscularis propria layer.

scholarly journals Use of anticoagulants increases risk of bleeding after colorectal endoscopic submucosal dissection

2018 ◽  
Vol 06 (07) ◽  
pp. E857-E864 ◽  
Author(s):  
Ken Yamashita ◽  
Shiro Oka ◽  
Shinji Tanaka ◽  
Kazuki Boda ◽  
Daiki Hirano ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Perioperative Period ◽  
University Hospital ◽  
En Bloc ◽  
Risk Of Bleeding ◽  
Warfarin Group ◽  
Submucosal Dissection ◽  
Clinical Records

Abstract Background and study aims Japanese guidelines for gastroenterological endoscopy have recommended temporary withdrawal of anticoagulants (warfarin, direct oral anticoagulants [DOAC], or heparin) to prevent hemorrhagic complications during endoscopic submucosal dissection (ESD) for colorectal neoplasias (CRNs). However, serious thrombosis might occur during temporary withdrawal of anticoagulants. The current study aimed to evaluate outcomes with anticoagulants in patients undergoing ESD for CRNs. Patients and methods This study was a single-institution retrospective cohort study based on clinical records. We assessed 650 consecutive patients with 698 CRNs who underwent ESD at Hiroshima University Hospital between December 2010 and June 2016. The patients were divided into three groups: the warfarin group (19 patients with 19 CRNs), DOAC group (7 patients with 9 CRNs), and no-antithrombotics group (624 patients with 670 CRNs). We replaced warfarin with heparin 3 to 5 days before endoscopy. Although DOAC was suspended on the morning of endoscopy, we did not replace heparin. Results Bleeding after the procedure occurred in 26.3 % (5/19), 22.0 % (2/9), and 2.7 % (18/670) of patients in the warfarin, DOAC, and no-antithrombotics groups, respectively. In the warfarin group, four patients who bled after the procedure took not only warfarin but also other antiplatelets. En bloc resection rates were 94.7 % (18/19), 100 % (9/9), and 96.6 % (647/670) in the warfarin, DOAC, and no-antithrombotics groups, respectively. No patients experienced ischemic events in the perioperative period. Conclusions Among patients undergoing ESD for CRNs, risk of bleeding was higher among patients who took anticoagulants than among those who did not. In particular, careful attention to patients who took antiplatelets in addition to warfarin before ESD for CRNs is warranted.

Su1580 Early Experience of Gastric Endoscopic Submucosal Dissection At a University Hospital in Colombia

2015 ◽  
Vol 81 (5) ◽  
pp. AB338
Author(s):  
Arecio Peñaloza ◽  
Carlos A. Sanchez ◽  
Pedro Nel Aponte ◽  
Hernando Kuan ◽  
Carlos Sabogal
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Early Experience ◽  
University Hospital ◽  
Submucosal Dissection
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