CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(05): E622-E624
DOI: 10.1055/a-0589-9850
Case report
Owner and Copyright © Georg Thieme Verlag KG 2018

Full-thickness resection with an over-the-scope device: possible translocation of adenoma tissue in a case of an incomplete resection at the appendix

Franz Ludwig Dumoulin
1   Department of Medicine and Gastroenterology, Gemeinschaftskrankenhaus Bonn, Bonn, Germany
,
Dominik G. Gorris
1   Department of Medicine and Gastroenterology, Gemeinschaftskrankenhaus Bonn, Bonn, Germany
,
Susanne Berger
2   Office for Internal Medicine, Cardiology and Gastroenterology, St. Augustin, Germany
,
Ralf Hildenbrand
3   Institute für Pathology Bonn-Duisdorf, Bonn, Germany
,
Bernd Sido
4   Department of General and Abdominal Surgery, Gemeinschaftskrankenhaus Bonn, Bonn, Germany
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Publikationsverlauf

submitted 03. November 2017

accepted after revision 12. Februar 2018

Publikationsdatum:
08. Mai 2018 (online)

Abstract

Background and study aims Clip-assisted endoscopic full-thickness resection has great potential for treatment of difficult-to-resect colorectal neoplasia. Here, we report on endoscopic full-thickness resection at the appendiceal orifice with the appendix in situ requiring emergency surgery due to acute appendicitis. Final histopathology showed appendicitis and residual serrated adenoma within the appendiceal stump, but unexpectedly, also a displaced adenoma fragment at the serosal surface of the cecum. Given the transmural placement of the clip prior to snare resection, translocation of neoplastic tissue to the extra luminal site in cases of incomplete adenoma/carcinoma resection could be a concern.

 
  • References

  • 1 Schurr MO, Buess G, Raestrup H. et al. Full thickness resection device (FTRD) for endoluminal removal of large bowel tumours: development of the instrument and related experimental studies. MITAT 2009; 10: 301-309
  • 2 Schurr MO, Baur FE, Krautwald M. et al. Endoscopic full-thickness resection and clip defect closure in the colon with the new FTRD system: experimental study. Surg Endosc 2015; 29: 2434-2441
  • 3 Sarker S, Gutierrez JP, Council L. et al. Over-the-scope clip-assisted method for resection of full-thickness submucosal lesions of the gastrointestinal tract. Endoscopy 2014; 46: 758-761
  • 4 Fahndrich M, Sandmann M. Endoscopic full-thickness resection for gastrointestinal lesions using the over-the-scope clip system: a case series. Endoscopy 2015; 47: 76-79
  • 5 Al-Bawardy B, Rajan E, Wong KeeSong LM. Over-the-scope clip-assisted endoscopic full-thickness resection of epithelial and subepithelial GI lesions. Gastrointest Endosc 2017; 85: 1087-1092
  • 6 Schmidt A, Beyna T, Schumacher B. et al. Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications. Gut 2017; DOI: 10.1136/gutjnl-2016-313677. [Epub ahead of print Aug 10]
  • 7 Baird DLH, Simillis C, Kontovounisios C. et al. Acute appendicitis. BMJ (Clinical research ed) 2017; 357: j1703
  • 8 Hirao M, Yamada T, Michida T. et al. Peritoneal seeding after gastric perforation during endoscopic submucosal dissection for gastric cancer. Dig Surg 2017; DOI: 10.1159/000481715. [Epub ahead of print Nov 8]
  • 9 Mege D, Petrucciani N, Maggiori L. et al. Peritoneal perforation is less a complication than an expected event during transanal endoscopic microsurgery: experience from 194 consecutive cases. Tech Coloproctol 2017; 21: 729-736