2019
DOI: 10.1016/j.gie.2018.10.008
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Look, but don’t touch: what not to do in managing large colorectal polyps

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Cited by 7 publications
(6 citation statements)
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References 16 publications
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“…Both tattooing underneath a lesion and prior incomplete endoscopic resection have been shown to cause submucosal fibrosis and complicate subsequent resection attempts. 23,24 Similarly, in this study, submucosal fibrosis was commonly identified in patients with a tattoo underneath the lesion (51 of 62 [82.3%]) and in those with prior incomplete EMR attempts (91 of 99 [92%]). On multivariate analysis, presence of severe submucosal fibrosis was the strongest predictor for failed ESD; further highlighting the detrimental consequences of both of these actions before definitive endoscopic resection.…”
Section: Discussionsupporting
confidence: 61%
“…Both tattooing underneath a lesion and prior incomplete endoscopic resection have been shown to cause submucosal fibrosis and complicate subsequent resection attempts. 23,24 Similarly, in this study, submucosal fibrosis was commonly identified in patients with a tattoo underneath the lesion (51 of 62 [82.3%]) and in those with prior incomplete EMR attempts (91 of 99 [92%]). On multivariate analysis, presence of severe submucosal fibrosis was the strongest predictor for failed ESD; further highlighting the detrimental consequences of both of these actions before definitive endoscopic resection.…”
Section: Discussionsupporting
confidence: 61%
“…The ability to optically characterize neoplasia through its biological hallmark behaviours could help optimize clinical diagnostic pathways by immediately indicating the nature of lesion and facilitate, in cases of benign aetiology, immediate local excision (or conversely caution such an approach in lesions with benign appearances but containing an invasive focus). Avoidance of biopsy is increasingly advocated in these cases as such an act can introduce architectural distortion in the samples and induce fibrosis in the residual lesion (confounding luminal excision) 32 . In lesions where biopsy is still indicated, the fluorescent signal profile could indicate the site of most relevant yield re cancer detection.…”
Section: Discussionmentioning
confidence: 99%
“…Detailed region by region biopsy collated to continuous FI perfusion criteria may too yield digital tumour margin delineation and heterogeneity appreciation. Greater patient numbers is of course needed too and, with early proof of principle now provided, a larger clinical study is now ongoing to develop and validate these findings 32 while AI methods are also being developed to enable real-time deployment 34 .…”
Section: Discussionmentioning
confidence: 99%
“…Benign lesions may be distinguished from malignancies based on endoscopic appearance using Kudo pit pattern or NICE classification [ 26 , 27 ]. Some argue benign appearing lesions shouldn’t be biopsied excessively, if at all, if advanced endoscopic resection is to be considered due to the possibility of fibrosis [ 30 ]. Therefore, the optimal technique of endoscopic biopsy for colorectal lesions remains unclear.…”
Section: Discussionmentioning
confidence: 99%