UNDERWATER ENDOSCOPIC SUBMUCOSAL DISSECTION OF A RECURRENT COLONIC ADENOMA

A patient with recurrent adenoma after piecemeal resection of a transverse colon LST was referred to our hospital. Endoscopy showed two sessile polyps (Kudo IV) with central scar (30 mm in total). Colon was filled with saline, underwater ESD was performed using Dual Knife (Olympus, Tokyo). Due to severe fibrosis, it was impossible to dissect mucosal and muscolar layers so we resected muscular tissue, preserving serosal layer. Dissection was completed and tumor removed en bloc without adverse events. Specimen showed HGD adenoma and R0. Our case shows that underwater ESD is safe and effective for recurrent adenomas with severe fibrosis.

Publication History

Article published online:
14 April 2022