A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecation
Background and study aims: Endoscopic submucosal dissection (ESD) has been developed to facilitate en bloc resection of large lesions. However, it is laborious to retrieve the large colorectal specimens. We propose a novel retrieval technique using a Valsalva maneuver, known as Tumor Extraction by D...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2016-01-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-107902 |
| _version_ | 1818684749210714112 |
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| author | Daiki Nemoto Yoshikazu Hayashi Kenichi Utano Noriyuki Isohata Shungo Endo Alan K Lefor Hironori Yamamoto Kazutomo Togashi |
| author_facet | Daiki Nemoto Yoshikazu Hayashi Kenichi Utano Noriyuki Isohata Shungo Endo Alan K Lefor Hironori Yamamoto Kazutomo Togashi |
| author_sort | Daiki Nemoto |
| collection | DOAJ |
| description | Background and study aims: Endoscopic submucosal dissection (ESD) has been developed to facilitate en bloc resection of large lesions. However, it is laborious to retrieve the large colorectal specimens. We propose a novel retrieval technique using a Valsalva maneuver, known as Tumor Extraction by Defecation (TED).
Case series: A total of nine lesions (median size 88 mm, maximum 225 mm; proximal colon three, rectum six) that could not be easily retrieved using net forceps were subsequently removed by TED. The rectum was filled with water through the colonoscope. The patient then strained to evacuate the specimen, facilitated by an almost straight anorectal angle. All specimens were retrieved without fragmentation, within minutes. Histology was assessed appropriately, including an adenoma in two and mucosal cancer in seven. All cut margins were verified to be negative. No adverse events occurred.
Conclusions: TED is a promising technique for retrieving large colorectal specimens after ESD. |
| first_indexed | 2024-12-17T10:55:34Z |
| format | Article |
| id | doaj.art-592e90f191a6409599e7fe7ac76a8e02 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-17T10:55:34Z |
| publishDate | 2016-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-592e90f191a6409599e7fe7ac76a8e022022-12-21T21:51:49ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362016-01-010401E93E9510.1055/s-0041-107902A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecationDaiki Nemoto0Yoshikazu Hayashi1Kenichi Utano2Noriyuki Isohata3Shungo Endo4Alan K Lefor5Hironori Yamamoto6Kazutomo Togashi7Department of Coloproctology, Aizu Medical Center, Fukushima Medical University, Fukushima 969-3492 JapanDepartment of Gastroenterology, Jichi Medical University, Tochigi 329-0498 JapanDepartment of Coloproctology, Aizu Medical Center, Fukushima Medical University, Fukushima 969-3492 JapanDepartment of Coloproctology, Aizu Medical Center, Fukushima Medical University, Fukushima 969-3492 JapanDepartment of Coloproctology, Aizu Medical Center, Fukushima Medical University, Fukushima 969-3492 JapanDepartment of Surgery, Jichi Medical University, Tochigi 329-0498 JapanDepartment of Gastroenterology, Jichi Medical University, Tochigi 329-0498 JapanDepartment of Coloproctology, Aizu Medical Center, Fukushima Medical University, Fukushima 969-3492 JapanBackground and study aims: Endoscopic submucosal dissection (ESD) has been developed to facilitate en bloc resection of large lesions. However, it is laborious to retrieve the large colorectal specimens. We propose a novel retrieval technique using a Valsalva maneuver, known as Tumor Extraction by Defecation (TED). Case series: A total of nine lesions (median size 88 mm, maximum 225 mm; proximal colon three, rectum six) that could not be easily retrieved using net forceps were subsequently removed by TED. The rectum was filled with water through the colonoscope. The patient then strained to evacuate the specimen, facilitated by an almost straight anorectal angle. All specimens were retrieved without fragmentation, within minutes. Histology was assessed appropriately, including an adenoma in two and mucosal cancer in seven. All cut margins were verified to be negative. No adverse events occurred. Conclusions: TED is a promising technique for retrieving large colorectal specimens after ESD.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-107902 |
| spellingShingle | Daiki Nemoto Yoshikazu Hayashi Kenichi Utano Noriyuki Isohata Shungo Endo Alan K Lefor Hironori Yamamoto Kazutomo Togashi A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecation Endoscopy International Open |
| title | A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecation |
| title_full | A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecation |
| title_fullStr | A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecation |
| title_full_unstemmed | A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecation |
| title_short | A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecation |
| title_sort | novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection tumor extraction by defecation |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-107902 |
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