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Traction-assisted endoscopic mucosal resection for polypectomy in the large intestine

Author(s): Bernhard Dauser, Thomas Winkler, Behrooz Salehi, Stefan Riss, Franz Beer, Friedrich Herbst

Journal: World Journal of Gastroenterology
ISSN 1007-9327

Volume: 16;
Issue: 43;
Start page: 5462;
Date: 2010;
Original page

Keywords: Traction-assisted | Endoscopic mucosal resection | Colon polyp | Colonoscopy

AIM: To evaluate if traction-assisted endoscopic mucosal resection (TA-EMR) is feasible and if it enables en bloc resection of colorectal lesions.METHODS: Seven patients with a total of 12 colorectal adenomas were prospectively enrolled. All lesions were removed by TA-EMR: one hemostatic clip tied to a white silk suture was applied to the base of the lesion to allow traction through the working channel of the colonoscope. A conventional polypectomy snare was mounted over the suture and the lesion was pulled into the snare and resected in one piece.RESULTS: All 12 lesions (nine sessile) were resected en bloc with free lateral and vertical margins by using this novel technique, including five lesions (5/12, 41.6%) in less-accessible positions, where TA-EMR enabled complete visualization of the base before resection. Mean longest lesion and specimen sizes were 9 mm (range: 6-25 mm) and 11 mm in diameter (range: 7-17 mm), respectively. No serious procedure-related complications were observed.CONCLUSION: TA-EMR through the endoscope using a hemostatic clip and suture material is technically feasible. Visualization of colorectal lesions in less-accessible locations can be improved.

Tango Rapperswil
Tango Rapperswil

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