51 research outputs found

    Endoscopic Full-Thickness Resection of Synchronous Adenocarcinomas of the Distal Rectum

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    Endoscopic full-thickness resection (EFTR) with an innovative full-thickness resection device (FTRD; Ovesco Endoscopy, Tübingen, Germany) allows a safe and complete full-thickness resection of early colorectal cancer. We present the first case of two EFTR performed at the same time to treat synchronous rectal adenocarcinomas

    Endoscopic Resection of a Giant Pedunculated Leiomyoma of the Sigmoid Colon

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    The leiomyoma is a benign smooth muscle tumor and may occur throughout the entire digestive tract, more frequently in the stomach, and small intestine, but is rarely seen in large bowel. Furthermore, a colonic giant pedunculated leiomyoma is very rare. The traditional management option for a colonic leiomyoma is surgical resection. However, the endoloop‑assisted polypectomy could be the treatment of choice even for very large lesions

    Superficial neoplasia involving the Ileocecal valve: Clinical outcomes of endoscopic submucosal dissection

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    BACKGROUND: Endoscopic submucosal dissection (ESD) is the treatment of choice for colorectal superficial neoplasia, but certain anatomical locations are challenging even for skilled endoscopists. Ileocecal valve (ICV) is considered a technically challenging site for ESD. OBJECTIVE: Aim of this study was to analyze efficacy and safety of Endoscopic Submucosal Dissection in the treatment of colorectal neoplasia involving the ileocecal valve (ICV) DESIGN: Retrospective study. PATIENTS: We retrospectively evaluated 1507 consecutive patients undergoing ESD at two tertiary referral centres for ESD (Italy and Japan) from January 2008 to March 2020. MAIN OUTCOME MEASURES: Demographic, clinical, procedural, and follow-up data was collected, analysed, and compared between patients with ileocecal valve lesions (ICVL) and patients with non-ICVL. RESULTS: Overall, 1507 patients were enrolled (872 M, 57.8%), of these 53 patients had lesions involving the ICV. Mean age was 70.2 years (range, 53-83 years). En-bloc resection was achieved in 52 (98%) patients. The median specimen size of ICVL was 36.4 mm (range, 8-80 mm), significantly smaller than non-ICVL (p = 0.005). Procedure time was significantly longer in the ICVL group, (71.3 vs. 58.9 min; p = 0.03). Non Granular Type Laterally Spreading Tumors (LST-NG) were significantly more frequent in the ICVL group compared to rectum (52.8% vs. 25.7; p = 0.0001). En-bloc resection rate in the ileocecal region did not differ significantly between groups (p = 0.20). Complications such as perforation and postoperative occurred respectively in 3/53 (5.7%) and 1/53 (2%) patient, and were treated conservatively. At first surveillance colonoscopy performed at 6 months, recurrent adenoma was detected in 2/53 patients (3.9%). CONCLUSIONS: ESD is safe and effective for the treatment of colorectal neoplasia involving the ileocecal valve if performed by expert endoscopist in referral centres
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