Endoscopic management of difficult laterally spreading tumors in colorectum.
Colorectal polyps
Endoscopic full thickness resection
Endoscopic mucosal resection
Endoscopic submucosal dissection
Laterally spreading tumors
Underwater endoscopic mucosal resection
Journal
World journal of gastrointestinal endoscopy
ISSN: 1948-5190
Titre abrégé: World J Gastrointest Endosc
Pays: United States
ID NLM: 101532474
Informations de publication
Date de publication:
16 Mar 2022
16 Mar 2022
Historique:
received:
30
06
2021
revised:
01
11
2021
accepted:
15
02
2022
entrez:
18
4
2022
pubmed:
19
4
2022
medline:
19
4
2022
Statut:
ppublish
Résumé
Due to the advent of the screening programs for colorectal cancer and the era of quality assurance colonoscopy the number the polyps that can be considered difficult, including large (> 20 mm) laterally spreading tumors (LSTs), has increased in the last decade. All LSTs should be assessed carefully, looking for suspicious areas of submucosal invasion (SMI), such as nodules or depressed areas, describing the morphology according to the Paris classification, the pit pattern, and vascular pattern. The simplest, most appropriate and safest endoscopic treatment with curative intent should be selected. For LST-granular homogeneous type, piecemeal endoscopic mucosal resection should be the first option due to its biological low risk of SMI. LST-nongranular pseudodepressed type has an increased risk of SMI, and en bloc resection should be mandatory. Underwater endoscopic mucosal resection is useful in situations where submucosal injection alters the operative field,
Identifiants
pubmed: 35432746
doi: 10.4253/wjge.v14.i3.113
pmc: PMC8984535
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
113-128Informations de copyright
©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
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