Underwater cap-suction pseudopolyp formation for endoscopic mucosal resection: a simple technique for treating flat, appendiceal orifice or ileocecal valve colorectal lesions.
Journal
Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
medline:
30
10
2023
pubmed:
23
6
2023
entrez:
22
6
2023
Statut:
ppublish
Résumé
We aimed to evaluate the safety and technical success of an easy-to-use technique that applies underwater cap suction pseudopolyp formation to facilitate the resection of flat lesions or those at the appendiceal orifice or ileocecal valve. We retrospectively analyzed a register of consecutive cap suction underwater endoscopic mucosal resection (CAP-UEMR) procedures performed at two centers between September 2020 and December 2021. Procedures were performed using a cone-shaped cap, extending 7 mm from the endoscope tip, to suction the lesion while submerged underwater, followed by underwater snare resection. Our primary end point was technical success, defined as macroscopic complete resection. We treated 83 lesions (median size 20 mm; interquartile range [IQR] 15-30 mm) with CAP-UEMR: 64 depressed or flat lesions (18 previously manipulated, 9 with difficult access), 11 from the appendix, and 8 from the ileocecal valve. Technical success was 100 %. There were seven intraprocedural bleedings and two delayed bleedings, all managed endoscopically. No perforations or other complications occurred. Among the 64 lesions with follow-up colonoscopy, only one recurrence was detected, which was treated endoscopically. CAP-UEMR was a safe and effective technique for removing nonpolypoid colorectal lesions, including those arising from the appendiceal orifice or ileocecal valve.
Sections du résumé
BACKGROUND
We aimed to evaluate the safety and technical success of an easy-to-use technique that applies underwater cap suction pseudopolyp formation to facilitate the resection of flat lesions or those at the appendiceal orifice or ileocecal valve.
METHODS
We retrospectively analyzed a register of consecutive cap suction underwater endoscopic mucosal resection (CAP-UEMR) procedures performed at two centers between September 2020 and December 2021. Procedures were performed using a cone-shaped cap, extending 7 mm from the endoscope tip, to suction the lesion while submerged underwater, followed by underwater snare resection. Our primary end point was technical success, defined as macroscopic complete resection.
RESULTS
We treated 83 lesions (median size 20 mm; interquartile range [IQR] 15-30 mm) with CAP-UEMR: 64 depressed or flat lesions (18 previously manipulated, 9 with difficult access), 11 from the appendix, and 8 from the ileocecal valve. Technical success was 100 %. There were seven intraprocedural bleedings and two delayed bleedings, all managed endoscopically. No perforations or other complications occurred. Among the 64 lesions with follow-up colonoscopy, only one recurrence was detected, which was treated endoscopically.
CONCLUSIONS
CAP-UEMR was a safe and effective technique for removing nonpolypoid colorectal lesions, including those arising from the appendiceal orifice or ileocecal valve.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1045-1050Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
H. Uchima is consultant for Lumendi, collaborates with ERBE Spain, Olympus Iberia, and Izasa, and has received congress registration from Casen-Recordati. M. Pellisé has served on clinical advisory boards for Fujifilm Europe and MiWendo; owns share options in MiWendo; has received speaker fees from Casen Recordati, Norgine Iberia, Fujifilm, Medtronic, and Olympus; and has received research funding from Fujifilm, Casen Recordati, Ziuz, and 3-D Matrix. A. Calm, R. Muñoz-González, N. Caballero, M. Rosinach, I. Marín, J. Colán-Hernández, I. Iborra, E. Castillo-Regalado, R. Temiño, A. Mata, R. Turró, J. Espinós, and V. Moreno De Vega declare that they have no conflict of interest.