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Perspectives in endoscopic mucosal resection.

R H Hawes1

  • 1Digestive Disease Center, Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston 29425, USA.

Gastrointestinal Endoscopy Clinics of North America
|January 10, 2002
PubMed
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Endoscopic mucosal resection evolved from colonoscopy and snare polypectomy for colon polyps. However, large sessile lesions pose risks like perforation, especially in the cecum and ascending colon.

Area of Science:

  • Gastroenterology and Endoscopy
  • Surgical Techniques and Innovation

Background:

  • Colonoscopy and polypectomy are established endoscopic procedures.
  • Pedunculated and sessile lesions are commonly encountered during colonoscopy.
  • Snare polypectomy is the standard for managing colon polyps.

Purpose of the Study:

  • To trace the origins of endoscopic mucosal resection (EMR).
  • To highlight challenges associated with current polypectomy techniques for large sessile lesions.
  • To identify the primary complications of snare polypectomy.

Main Methods:

  • Historical review of endoscopic procedures.
  • Analysis of techniques for colon polyp removal.
  • Identification of complications associated with snare polypectomy.

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Main Results:

  • Endoscopic mucosal resection likely originated from early colonoscopy and polypectomy practices.
  • Snare polypectomy is effective for most colon polyps.
  • Large sessile lesions, particularly in the cecum and ascending colon, present significant challenges.

Conclusions:

  • The evolution of endoscopic mucosal resection is linked to advancements in colonoscopy.
  • Current polypectomy techniques face limitations with large sessile colonic lesions.
  • Serosal burns and perforations are major risks of snare polypectomy for challenging lesions.