| Theme | Current Endoscopic Treatment for Colorectal Tumors | |
|---|---|---|
| Title | Colorectal ESD for Residual and Locally Recurrent Lesions post Endoscopic Resection | |
| Publish Date | 2014/02 | |
| Author | Shinwa Tanaka | Department Endoscopy, Kobe University Hospital |
| Author | Takashi Toyonaga | Department Endoscopy, Kobe University Hospital |
| [ Summary ] | Colorectal ESD for residual and locally recurrent lesions after endoscopic resection is technically difficult. The technical aspects of colorectal ESD for these lesions are described. In making mucosal incisions, creating a "mucosal flap" in the mucosa it is important without having the fibrosis be distant from the scar. In submucosal dissection, blind manipulation should be avoided because of risk of perforation. If the muscle layer is confirmed on both sides when dissecting areas of severe fibrosis, the dissection line may be imaged by connecting both sides of the confirmed muscle layer. Continuing short distance dissection may lead to the completion of en bloc resection even in lesions with severe fibrosis. Understanding techniques helps us to complete resection even in residual or locally recurrent lesions after endoscopic resection. | |