Tips and Tricks for Better Endoscopic Treatment of Colorectal Tumors: Usefulness of Cap and Band in Colorectal Endoscopic Mucosal Resection

Park, Seun Ja

doi:10.5946/ce.2013.46.5.492

Cited by 10 publications

(5 citation statements)

References 18 publications

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“…R-NETs commonly appear as submucosal lesions with yellowish mucosa [ 14 , 15 ]. There is still controversy on the treatment of R-NETs, and numerous treatment strategies have been reported [ 7 , 16 ], including EMR, EMR-c, EMR-l, ESD, etc. In this study, we retrospectively analyzed the safety and effectiveness of EMR-c and ESD in R-NETs ≤ 15 mm, and predicted the risk factors of incomplete resection.…”

Section: Discussionmentioning

confidence: 99%

Comparison between endoscopic mucosal resection with a cap and endoscopic submucosal dissection for rectal neuroendocrine tumors

Zheng

Shi

et al. 2022

BMC Surg

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Background The aim of this study is to evaluate and compare the safety and efficacy of endoscopic mucosal resection with a cap (EMR-c) with those of endoscopic submucosal dissection (ESD) for rectal neuroendocrine tumors (R-NETs) ≤ 15 mm in diameter, and to analyze the risk factors of incomplete resection. Methods A total of 122 patients who underwent EMR-c or ESD for R-NETs at the Fourth Hospital of Hebei Medical University between February 2007 and December 2020 were invovled in this study. The clinical outcomes of two groups were compared and evaluated. Results A total of 122 patients with 128 R-NETs underwent endoscopic resection (EMR-c, 80; ESD, 48). In terms of duration of operation, EMR-c was significantly shorter than ESD (p < 0.001). Univariate analysis and multivariate analysis suggested that tumor diameter ≥ 8 mm was an independent risk factor for incomplete resection in patients with R-NETs in this study. Conclusions Both EMR-c and ESD were safe and effective treatments for R-NETs ≤ 15 mm in diameter. In addition, tumor diameter ≥ 8 mm was an independent risk factor for incomplete resection.

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Section: Discussionmentioning

confidence: 99%

Comparison between endoscopic mucosal resection with a cap and endoscopic submucosal dissection for rectal neuroendocrine tumors

Zheng

Shi

et al. 2022

BMC Surg

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“…The 'Cap and band' method was reported to be used in colon mucosal lesion resection [9] . With sufficient aspiration and band ligation performed using a cap-mounted endoscope, completely ligated, all-layers circular-resected specimens can be obtained without residue tumor.…”

Section: Discussionmentioning

confidence: 99%

Ligation-Assisted Endoscopic Enucleation for the Resection of Gastrointestinal Tumors Originating from the Muscularis Propria: Analysis of Efficacy and Facility

Zeng

Jiao²,

Wang³

et al. 2016

Dig Surg

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Background: Gastrointestinal tumors originating from the muscularis propria are believed to have the potential to progress to malignant tumors. The efficacy of ‘pre-management' with elastic band or endoloop assistant ligation after initial submucosal dissection in endoscopic enucleation procedure of these tumors was investigated and evaluated. Methods: The study included 21 patients with small gastric stromal tumors arising in the gastric muscularis propria as determined by endoscopy (endoscopic ultrasonography). A standard endoscope with a transparent cap attached to the tip was used. The cap was placed over the lesion, after incision of the surrounding tissue, maximum sustained suction was applied. Then the elastic band or endoloop was released around the base. Circumference resection was performed with clips strengthening the defect closure. Results: The 22 gastrointestinal stromal tumors sloughed completely. The mean time required for the full-thickness resection was 48 min. Minor perforation occurred with metal clips closing the defect of the gastric wall. Follow-up ranged from 13 to 42 months, during which time no recurrence was observed postoperatively. Conclusions: The band or endoloop assistant endoscopic ligation technique is effective for the enucleation of deep gastric tumors. It may help avoiding disturbance the abdominal cavity hemostasis in traditional full-thickness enucleation procedure.

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“…The cap-assisted EMR (C-EMR) and EMR with a ligation device (EMR-L) in the colon have limited indications, especially for R0 resection of small rectal neuroendocrine tumors (NETs) because their radical removal can be difficult to achieve with standard endoscopic resection techniques due to the frequent involvement of the submucosal layer[ 76 , 77 ].…”

Section: Jnet Classificationmentioning

confidence: 99%

Indications and outcomes of endoscopic resection for non-pedunculated colorectal lesions: A narrative review

Shahini¹,

Libânio²,

Secco³

et al. 2021

WJGE

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In the last years, endoscopic techniques gained a crucial role in the treatment of colorectal flat lesions. At the same time, the importance of a reliable assessment of such lesions to predict the malignancy and the depth of invasion of the colonic wall emerged. The current unsolved dilemma about the endoscopic excision techniques concerns the necessity of a reliable submucosal invasive cancer assessment system that can stratify the risk of the post-procedural need for surgery. Accordingly, this narrative literature review aims to compare the available diagnostic strategies in predicting malignancy and to give a guide about the best techniques to employ. We performed a literature search using electronic databases (MEDLINE/PubMed, EMBASE, and Cochrane Library). We collected all articles about endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) registering the outcomes. Moreover, we analyzed all meta-analyses comparing EMR vs ESD outcomes for colorectal sessile or non-polypoid lesions of any size, preoperatively estimated as non-invasive. Seven meta-analysis studies, mainly Eastern, were included in the analysis comparing 124 studies and overall 22954 patients who underwent EMR and ESD procedures. Of these, eighty-two were retrospective, twenty-four perspective, nine case-control, and six cohorts, while three were randomized clinical trials. A total of 18118 EMR and 10379 ESD were completed for a whole of 28497 colorectal sessile or non-polypoid lesions > 5-10 mm in size. In conclusion, it is crucial to enhance the preoperative diagnostic workup, especially in deciding the most suitable endoscopic method for radical resection of flat colorectal lesions at risk of underlying malignancy. Additionally, the ESD necessitates further improvement because of the excessively time-consuming as well as the intraprocedural technical hindrances and related complications. We found a higher rate of en bloc resections and R0 for ESD than EMR for non-pedunculated colorectal lesions. Nevertheless, despite the lower local recurrence rates, ESD had greater perforation rates and needed lengthier procedural times. The prevailing risk for additional surgery in ESD rather than EMR for complications or oncologic reasons is still uncertain.

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Tips and Tricks for Better Endoscopic Treatment of Colorectal Tumors: Usefulness of Cap and Band in Colorectal Endoscopic Mucosal Resection

Cited by 10 publications

References 18 publications

Comparison between endoscopic mucosal resection with a cap and endoscopic submucosal dissection for rectal neuroendocrine tumors

Comparison between endoscopic mucosal resection with a cap and endoscopic submucosal dissection for rectal neuroendocrine tumors

Ligation-Assisted Endoscopic Enucleation for the Resection of Gastrointestinal Tumors Originating from the Muscularis Propria: Analysis of Efficacy and Facility

Indications and outcomes of endoscopic resection for non-pedunculated colorectal lesions: A narrative review

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