Sa1611 Endoscopic Mucosal Resection With CAP Demonstrates a Superior Rate of Histologic Complete Resection Over Endoscopic Submucosal Dissection for Rectal Neuroendocrine Tumors

Lim, Tae Won; Ryu, Dae Gon; Kim, Wan Chul; Nam, Hyeong Seok; Kang, Dae Hwan; Kim, Hyung Wook; Choi, Cheol Woong; Park, Su Bum

doi:10.1016/j.gie.2015.03.1400

Cited by 2 publications

(1 citation statement)

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“…There is some evidence to suggest that cap-assisted EMR significantly shortens procedure time in comparison with EMR or ESD without a cap in removing rectal tumours. 48,49 There are as yet no head to head trials comparing cap versus non-cap assisted ESD. Hoods are a type of cap with a tapered tip that can be used to elevate mucous membranes following the initial incision to aid with submucosal dissection.…”

Section: Distal Attachmentsmentioning

confidence: 99%

Endoscopic submucosal dissection: an update on tools and accessories

Harlow

Sivananthan

Ayaru

et al. 2020

Clin Med Insights Gastroenterol

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Endoscopic submucosal dissection (ESD) is a minimally invasive therapeutic procedure to remove larger polyps or early non-metastatic lesions. It has long been used in Asia, but is now fast growing in popularity in the West. There are multiple challenges faced by ESD practitioners. While the practice of ESD in gastric lesions is relatively well established, the oesophagus with its narrow lumen and challenging workspace, and the colon with its tortuous course and folds are more challenging frontiers. The nature of performing a procedure endoscopically means that conventional methods offer no mechanism for providing counter-traction while performing dissection, impeding visibility and increasing the rate of complications. There are a multitude of tools available to those performing ESD for the different stages of the procedure. This article reviews the accessories currently used in regular ESD practice including the knives used to cut and dissect lesions, the cap and hood devices used to improve visibility and safety, injection fluids to lift the submucosal plane, haemostatic devices, generators, and finally, emerging traction apparatus. There is some evidence behind the use of these tools, however, ESD remains the domain of a small number of practitioners and the practice relies heavily on expert experience. Evolution of the ESD toolbox will make the procedure more accessible to more endoscopists, which in turn will drive the development of a more substantial evidence base to evaluate efficacy and safety of the multitude of tools.

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Section: Distal Attachmentsmentioning

confidence: 99%