title: Thin endoscope-assisted endoscopic submucosal dissection for large colorectal tumors (with videos).
abstract: BACKGROUND
  Endoscopic submucosal dissection (ESD) enables direct submucosal dissection so even large early stage GI tumors can be resected en bloc. Colorectal ESD is technically more difficult, however, and there is an increased risk of complications such as perforation and bleeding compared with gastric ESD. As a result, further refinements are required in this procedure.
  
  
  OBJECTIVE
  Our purpose was to evaluate thin endoscope-assisted (TEA) ESD, a new traction system for improving submucosal cutting line visualization.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Okayama University Hospital.
  
  
  METHODS
  Efficacy and safety of the TEA-ESD procedure.
  
  
  RESULTS
  Three cases of large, flat, elevated colorectal tumors (laterally spreading tumors) in the rectum and rectosigmoid colon were safely and successfully removed en bloc without complications. Total procedure times were 3 hours, 40 minutes, and 30 minutes with resected specimens measuring 70 x 68 mm, 38 x 35 mm, and 30 x 20 mm, respectively.
  
  
  CONCLUSIONS
  TEA-ESD was performed in only the rectum and rectosigmoid colon.
  
  
  CONCLUSIONS
  This limited case series demonstrated that large laterally spreading tumors in the rectum and rectosigmoid colon could be safely resected en bloc with TEA-ESD.
authors: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
authors: Toshio
authors: T
authors: Uraoka
authors: Jun
authors: J
authors: Kato
authors: Shin
authors: S
authors: Ishikawa
authors: Keita
authors: K
authors: Harada
authors: Motoaki
authors: M
authors: Kuriyama
authors: Koji
authors: K
authors: Takemoto
authors: Yoshiro
authors: Y
authors: Kawahara
authors: Yutaka
authors: Y
authors: Saito
authors: Hiroyuki
authors: H
authors: Okada
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D017115:Catheter Ablation / Q000295:instrumentation*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged