title: Self-assembled hydro-jet system for submucosal elevation before endoscopic resection of nonpolypoid colorectal lesions (with video).
abstract: BACKGROUND
  Endoscopic resection of colorectal nonpolypoid lesions requires adequate submucosal lifting of the lesion.
  
  
  OBJECTIVE
  To evaluate a self-assembled hydro-jet system for tissue elevation to improve endoscopic resection of colorectal nonpolypoid lesions.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Single-center teaching hospital.
  
  
  METHODS
  Efficacy and safety of the hydro-jet system and rate of complete resection.
  
  
  RESULTS
  The system was clinically applied in 31 patients to remove a total of 34 lesions throughout the colon. An adequate submucosal fluid cushion was achieved in all but 1 case without any lifting-associated complications. Complete endoscopic resection was possible in all 33 lifted lesions by using a snare. The size of the resected lesions ranged from 7 to 60 mm. Major intraprocedure bleeding occurred in only 1 case. No perforation or late bleeding was recorded. Histological examination showed a selective accumulation of fluid in the submucosa with edema and dissociation of submucosal structures, with no damage to the muscularis mucosa and very limited "burn effect" hampering assessment of radial margins.
  
  
  CONCLUSIONS
  Lack of controls.
  
  
  CONCLUSIONS
  This inexpensive system allows safe and rapid submucosal lifting of colorectal nonpolypoid lesions to assist endoscopic resection.
authors.affiliation: Division of Gastroenterology, ASL NA5, Hospital A. Maresca, Torre del Greco, Italy.
authors.forename: Livio
authors.initials: L
authors.lastname: Cipolletta
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rotondano
authors.forename: Maria A
authors.initials: MA
authors.lastname: Bianco
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Garofano
authors.forename: Costantino
authors.initials: C
authors.lastname: Meucci
authors.forename: Antonio
authors.initials: A
authors.lastname: Prisco
authors.forename: Fabio
authors.initials: F
authors.lastname: Cipolletta
authors.forename: Roberto
authors.initials: R
authors.lastname: Piscopo
mesh_terms: D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D004210:Dissection / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007277:Injections, Jet / Q000295:instrumentation*; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome; D014741:Video Recording; D014867:Water
chemical_list: D014867:Water