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endoscopic full thickness resection

Hiroya Takeuchi, Osamu Goto, Naohisa Yahagi, Yuko Kitagawa
Recent meta-analyses and a prospective multicenter trial of sentinel node (SN) mapping in early gastric cancer have demonstrated acceptable SN detection rates and accuracy of determination of lymph node status. SN mapping may play a key role in obtaining individual metastatic information. It also allows modification of surgical procedures, including function-preserving gastrectomy in patients with early gastric cancer. A dual-tracer method that uses radioactive colloids and blue dye is currently considered the most reliable method for the stable detection of SNs in patients with early gastric cancer...
October 6, 2016: Gastric Cancer
Yiqun Zhang, Liqing Yao, Meidong Xu, Tyler M Berzin, Quanlin Li, Weifeng Chen, Jianwei Hu, Yan Wang, Mingyan Cai, Wenzheng Qin, Jiaxin Xu, Yuan Huang, Pinghong Zhou
OBJECTIVE: The objective of this study is to evaluate the feasibility and efficacy of endoscopic full-thickness resection (EFTR) and fully covered retrievable self-expandable metal stents (SEMSs) placement for this kind of tumors. METHODS: A total of six consecutive patients, presenting with esophageal and GE junction SMTs, received EFTR and SEMSs placement at the our endoscopic center between January 2015 and June 2015. Their medical records were thoroughly investigated...
September 15, 2016: Scandinavian Journal of Gastroenterology
Jae-Uk Jeong, Taek-Keun Nam, Hyeong-Rok Kim, Hyun-Jeong Shim, Yong-Hyub Kim, Mee Sun Yoon, Ju-Young Song, Sung-Ja Ahn, Woong-Ki Chung
BACKGROUND: After local excision of early rectal cancer, revision radical resection is recommended for patients with high-risk pathologic stage T1 (pT1) or pT2 cancer, but the revision procedure has high morbidity rates. We evaluated the efficacy of adjuvant concurrent chemoradiotherapy (CCRT) for reducing recurrence after local excision in these patients. METHODS: Eighty-three patients with high-risk pT1 or pT2 rectal cancer underwent postoperative adjuvant CCRT after local excision...
2016: Radiation Oncology
Badr Al-Bawardy, Elizabeth Rajan, Louis M Wong Kee Song
BACKGROUND AND AIMS: Endoscopic full-thickness resection (EFTR) allows for definitive diagnosis and treatment of select subepithelial and epithelial lesions unsuitable to conventional resection techniques. Our aim was to evaluate the efficacy and safety of over-the-scope (OTS) clip-assisted EFTR for these lesions. METHODS: Patients who underwent OTS clip-assisted EFTR between June 2014 and October 2015 were analyzed. The procedure involved (1) thermal marking of the periphery of the lesion; (2) lesion suction into the cap of either an OTSC (Ovesco Endoscopy AG, Tübingen, Germany) or Padlock clip (Aponos Medical Corp, Kingston, NH, USA) with or without triprong anchor retraction of the lesion; (3) clip deployment; and (4) en bloc resection of the lesion above the clip using an electrosurgical snare and/or knife...
August 26, 2016: Gastrointestinal Endoscopy
Ken Ohata, Kouichi Nonaka, Eiji Sakai, Yohei Minato, Hitoshi Satodate, Kazuteru Watanabe, Nobuyuki Matsuhashi
Recently, laparoscopic and/or endoscopic full-thickness resection (FTR) has been reported to be a useful technique for the treatment of superficial duodenal neoplasms (SDNs). In the current study, we evaluated clinical outcomes in 5 consecutive patients who underwent resection of nonampullary SDNs using laparoscopy-assisted endoscopic full-thickness resection with ligation Device (LAEFTR-L), which is an alternative FTR method developed to avoid peritoneal dissemination. Using a snare technique with a ligation band, the duodenal lesions were easily resected...
July 2016: Endoscopy International Open
Beibei Sun, Jintao Guo, Nan Ge, Siyu Sun, Sheng Wang, Xiang Liu, Guoxin Wang, Linlin Feng
OBJECTIVE: The secure closure of the wall defect is a critical stage of endoscopic full-thickness resection (EFTR). The aim of this study was to compare the closure of post-EFTR defects using an endoscopic ultrasound-guided puncture suture device (PSD) with the metal clip (MC) technique in a randomized, comparative, porcine study. METHODS: We performed a randomized comparative survival study that included 18 pigs. The circular EFTR defects with a diameter of approximately 20 mm were closed with either a PSD or MC...
July 2016: Endoscopic Ultrasound
Deepanshu Jain, Ejaz Mahmood, Aakash Desai, Shashideep Singhal
AIM: To do systematic review of current literature for endoscopic full thickness resection (EFTR) technique for gastric tumors originating from muscularis propria. METHODS: An extensive English literature search was done till December 2015; using PubMed and Google scholar to identify the peer reviewed original and review articles using keywords-EFTR, gastric tumor, muscularis propria. Human only studies were included. The references of pertinent studies were manually searched to identify additional relevant studies...
July 25, 2016: World Journal of Gastrointestinal Endoscopy
Eri Maeda, Masao Fujiwara, Hironobu Suto, Eisuke Asano, Takayoshi Kishino, Naoki Yamamoto, Shintaro Akamoto, Keiichi Okano, Hideki Kobara, Hirohito Mori, Tsutomu Masaki, Yasuyuki Suzuki
The typical treatment of choice for gastrointestinal stromal tumors (GIST) is surgical resection. Here we report a case of three GIST lesions resected safely by laparoscopic-endoscopic cooperative surgery (LECS). A 78-year-old woman was referred to our hospital for further treatment of an enlarging gastric submucosal tumor. Esophagogastroduodenoscopy and endoscopic ultrasonography revealed two gastric submucosal tumors. Endoscopic ultrasonography-guided fine needle aspiration was subsequently performed. The patient underwent LECS in accordance with therapeutic guidelines for GIST...
July 29, 2016: Asian Journal of Endoscopic Surgery
Osamu Goto, Hiroya Takeuchi, Motoki Sasaki, Hirofumi Kawakubo, Teppei Akimoto, Ai Fujimoto, Yasutoshi Ochiai, Tadateru Maehata, Toshihiro Nishizawa, Yuko Kitagawa, Naohisa Yahagi
Background and study aims: To avoid bacterial contamination and tumor seeding during gastrectomy surgery, we developed a nonexposure technique for endoscopic full-thickness resection with laparoscopic assistance. The feasibility and safety of nonexposed endoscopic wall-inversion surgery (NEWS) for gastric subepithelial tumors (SETs) were investigated. Patients and methods: For protruding gastric SETs ≤ 3 cm in diameter, NEWS was performed in the following sequence: laparoscopic seromuscular incision after endoscopic submucosal injection, laparoscopic seromuscular suturing with the lesion inverted, endoscopic mucosal and submucosal incision, and transoral retrieval...
July 22, 2016: Endoscopy
Jintao Guo, Beibei Sun, Siyu Sun, Xiang Liu, Sheng Wang, Nan Ge, Guoxin Wang, Wen Liu
BACKGROUND AND STUDY AIMS: Closure of gastric wall defects after endoscopic full-thickness resection remains a clinical challenge. We aimed to introduce an endoscopic puncture-suture device (EPSD) for the closure of such defects. We evaluated the safety, efficacy, and outcomes of EPSD in gastric wall defect closure after endoscopic full-thickness resection, compared with the metallic clips closure method. METHODS: Twenty-four Bama mini pigs (20-25 kg) were randomly divided into 2 groups...
June 27, 2016: Gastrointestinal Endoscopy
Dongtao Shi, Rui Li, Weichang Chen, Deqing Zhang, Lei Zhang, Rui Guo, Ping Yao, Xudong Wu
BACKGROUND: The key step of the endoscopic full-thickness resection (EFTR) procedure is the successful closure of any gastric wall defect which ultimately avoids surgical intervention. This report presents a new method of closing large gastric defects left after EFTR, using metallic clips and novel endoloops by means of single-channel endoscope. METHODS: We retrospectively analyzed 68 patients who were treated for gastric fundus gastrointestinal stromal tumors originating from the muscularis propria layer at four institutes between April 2014 and February 2015 and consequently underwent EFTR...
June 28, 2016: Surgical Endoscopy
Shinichi Kinami, Hiroshi Funaki, Hideto Fujita, Yasuharu Nakano, Nobuhiko Ueda, Takeo Kosaka
The local resection of the stomach is an ideal method for preventing postoperative symptoms. There are various procedures for performing local resection, such as the laparoscopic lesion lifting method, non-touch lesion lifting method, endoscopic full-thickness resection, and laparoscopic endoscopic cooperative surgery. After the invention and widespread use of endoscopic submucosal dissection, local resection has become outdated as a curative surgical technique for gastric cancer. Nevertheless, local resection of the stomach in the treatment of gastric cancer in now expected to make a comeback with the clinical use of sentinel node navigation surgery...
June 24, 2016: Surgery Today
Shingo Noura, Masayuki Ohue, Norikatsu Miyoshi, Masayoshi Yasui
Transanal endoscopic microsurgery (TEM) is a minimally invasive technique. However, TEM has not yet achieved widespread use. Recently, transanal minimally invasive surgery (TAMIS) using single-port surgery devices has been reported. In the present study, TAMIS using a GelPOINT(®) Path was performed in six patients with lower rectal cancer. A complete full-thickness excision was performed in all cases. The patient characteristics, operative techniques and operative outcomes were evaluated. The mean age of the patients was 63...
July 2016: Molecular and Clinical Oncology
Su Young Kim, Kyoung Oh Kim
With the wide use of esophagogastroduodenoscopy, the incidence of gastric subepithelial tumor (SET) diagnosis has increased. While the management of large or symptomatic gastric SETs is obvious, treatment of small (≤ 3 cm) asymptomatic gastric SETs remains inconclusive. Moreover, the presence of gastrointestinal stromal tumors with malignant potential is of concern, and endoscopic treatment of gastric SETs remains a subject of debate. Recently, numerous studies have demonstrated the feasibility of endoscopic treatment of gastric SETs, and have proposed various endoscopic procedures including endoscopic submucosal dissection, endoscopic muscularis dissection, endoscopic enucleation, endoscopic submucosal tunnel dissection, endoscopic full-thickness resection, and a hybrid approach (the combination of endoscopy and laparoscopy)...
June 10, 2016: World Journal of Gastrointestinal Endoscopy
B Meier, A Schmidt, K Caca
Conventional endoscopic resection techniques such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) are powerful tools for the treatment of gastrointestinal (GI) neoplasms. However, those techniques are limited to the superficial layers of the GI wall (mucosa and submucosa). Lesions without lifting sign (usually arising from deeper layers) or lesions in difficult anatomic positions (appendix, diverticulum) are difficult - if not impossible - to resect using conventional techniques, due to the increased risk of complications...
August 2016: Der Internist
Zhongqing Zheng, Guohui Jiao, Tao Wang, Xin Chen, Bangmao Wang
BACKGROUND: Gastrointestinal tumors originating from the muscularis propria are believed to have the potential to progress to malignant tumors. The efficacy of 'pre-management' with elastic band or endoloop assistant ligation after initial submucosal dissection in endoscopic enucleation procedure of these tumors was investigated and evaluated. METHODS: The study included 21 patients with small gastric stromal tumors arising in the gastric muscularis propria as determined by endoscopy (endoscopic ultrasonography)...
2016: Digestive Surgery
Meidong Xu, Qiang Cai
Endoscopic resection of gastrointestinal subepithelial tumors originating from muscularis propria is feasible and safe if performed by experienced hands. Large tumors with predominantly extraluminal growth and extensive connection of the tumor base with the muscularis propria are associated with less complete resection and more complications. An intact tumor capsule should be used as an indication of complete resection. Free air on images after endoscopic full-thickness resection may not be an accident. Submucosal endoscopic procedures are promising therapeutic procedures but are potentially associated with serious complications...
June 2016: American Journal of Gastroenterology
Laurie Hageman, Jolanda Strebus, Bas W van der Spek
With the introduction of a national screening program for colorectal cancer, an increasing number of colorectal neoplasias, including low-risk T1-carcinomas, is identified and resected endoscopically. Existing techniques for endoscopic resection do not always suffice. Currently, surgery is the only available option in these cases. Endoscopic full-thickness resection (eFTR) is a minimally invasive alternative to surgery for resection of non-lifting adenomas, adenomas in difficult-to-reach locations - such as the diverticulum - and for ensuring radical endoscopic resection in T1-carcinomas...
2015: Nederlands Tijdschrift Voor Geneeskunde
Viktor Rempel, Siegbert Faiss
Due to higher detection rates of early gastrointestinal neoplasia endoscopic resection of early GI cancers or precancerous lesions is increasing. Endoscopic piece-meal resection (EMR) remains the standard technique for the endoscopic resection of large sessile colorectal adenomas. Cap-assisted EMR techniques show excellent long-term results in the endoscopic therapy of neoplastic Barrett's esophagus. For the endoscopic resection of early gastrointestinal cancers of more than 2 cm endoscopic submucosal dissection (ESD) is the method of choice...
April 2016: Deutsche Medizinische Wochenschrift
Akiko Tonouchi, Takahiro Kinoshita, Hideki Sunagawa, Takuya Hamakawa, Akio Kaito, Hidehito Shibasaki, Takeshi Kuwata, Yosuke Seki, Toshirou Nishida
BACKGROUND: We herein report a case of a bronchogenic cyst arising from the esophagogastric junction treated by laparoscopic full-thickness extirpation. The full-thickness defect was closed by hand sewing a T-shaped line over the gastroendoscope as a bougie to prevent postoperative deformity or stenosis. Partial fundoplication (Toupet fundoplication) was added to prevent reflux. CASE PRESENTATION: A 32-year-old woman with a body mass index of 43 kg/m(2) was admitted for treatment of a cyst-forming submucosal tumor (60 mm in diameter) on the anterior wall of the esophagogastric junction, which was detected during screening endoscopy before bariatric surgery...
December 2016: Surgical Case Reports
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