Self-assembled hydro-jet system for submucosal elevation before endoscopic resection of nonpolypoid colorectal lesions (with video).
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.
Cipolletta
Livio
L
Division of Gastroenterology, ASL NA5, Hospital A. Maresca, Torre del Greco, Italy.
Rotondano
Gianluca
G
Bianco
Maria A
MA
Garofano
Maria Lucia
ML
Meucci
Costantino
C
Prisco
Antonio
A
Cipolletta
Fabio
F
Piscopo
Roberto
R
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
D014867:Water