Use of the endoscopic powered resection device for the management of scarred polyps

Wilson, Natalie; Are, Vijay S.; Cintron, Roberto Osorio; Azeem, Nabeel; Bilal, Mohammad

doi:10.1016/j.vgie.2023.01.009

Cited by 1 publication

(1 citation statement)

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“…During the surveillance colonoscopy, endoscopists can either biopsy the prior EMR scar if no residual/recurrent polypoid tissue is visible, or else a recent study has also shown the use of narrow-band imaging for scar (NBI-SCAR) classification for identifying recurrence, which has the potential to decrease the need for biopsies ( 27 ). Reassuringly, endoscopic methods can treat most local recurrences and several tools are now available for the management of recurrent polyps including hot avulsion, endoscopic full-thickness resection, ESD, and use of the powered endoscopic resection device ( 28 , 29 ).…”

Section: Discussionmentioning

confidence: 99%

Endoscopic mucosal resection: tips and tricks for gastrointestinal trainees

Herman¹,

Megna²,

Pallav³

et al. 2023

Transl Gastroenterol Hepatol

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Endoscopic mucosal resection (EMR) is a minimally invasive, specialized endoscopic technique that is useful in resecting superficial gastrointestinal lesions that are unable to be removed by standard polypectomy. This is typically accomplished using a submucosal injection that lifts the lesion away from the muscularis propria to allow for safe resection of the polyp, either via piecemeal or en bloc resection. Over the years, several techniques exist to perform EMR including conventional EMR or hot EMR, cold EMR and underwater EMR. Despite its established advantages and safety over conventional techniques such as surgery, the adoption of endoscopic resection (and thus the education and training of gastroenterology trainees) is lagging. The goal of this article is to offer a comprehensive review of the basic principles of colonic EMR. We review the concepts of optical diagnosis including the various polyp classification systems available to determine the polyp morphology and histology. We also discuss the technical aspects of performing colonic EMR. We also outline the common adverse events associated with EMR including bleeding, perforation, postpolypectomy syndrome, and residual or recurrent polyps, and discuss preventative measures that can be taken to mitigate adverse events. Lastly, we offer practical tips for trainees who want to undertake EMR in their clinical practice.

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Section: Discussionmentioning

confidence: 99%