Two-point fixed endoscopic submucosal dissection in rectal tumor (with video)

Background

Polypectomy, EMR, transanal endoscopic microsurgery, and surgery have been performed as treatments of rectal tumors. Endoscopic procedures are the least-invasive treatments for patients. Complete resection of the lesion is required to prevent its recurrence, and endoscopic submucosal dissection (ESD) has begun to be performed. With increasing requirements for safety, reliability, and simplicity in ESD, we decided to use a 2-point fixed ESD with a transparent hood fitted with a mucosal forceps channel in a case of a rectal tumor and report its usefulness.

Objective

To evaluate the safety, simplicity, and usefulness of 2-point fixed ESD performed on a rectal tumor.

Design

Case series.

Setting

Kanagawa Cancer Center Hospital.

Main Outcome Measurements

Safety, simplicity, and usefulness of 2-point fixed ESD performed on a rectal tumor.

Results

The mean duration of the procedure was 45 minutes (range 30-110 minutes). Hemostasis and manipulation of the vessels were easy in all patients who did not have postoperative bleeding, perforation, or retroperitoneal emphysema as complications.

Limitations

Uncontrolled study.

Conclusion

This study of 2-point ESD performed in 12 patients with rectal lesions revealed that the 2-point ESD with a transparent hood fitted with a mucosal forceps channel is a useful auxiliary device, enabling safe and reliable ESD on a rectal lesion.

Abbreviation: ESD, endoscopic submucosal dissection