Multiple Pockets ESD for a large 15 by 12 cms anorectal LST G mixed nodular polyp- Challenges faced and tricks for success

Abstract Text 70 year female – 95% circumferential 15 by 12cms Paris 1S + 2A, JNET 2A polyp from anal verge. Reluctant for surgery. ESD planned. Under GA Dissection started at anal verge. Posterior, right and left lateral and anterior tunnels made with ESD technique. Significant blood vessels and fibrosis encountered. After 12 hours two tunnels joined. Patient ventilated overnight, procedure done next morning. Patient position changed several times for gravity. Conclusion: Large LST and bulky component have severe fibrosis. Changing patient’s position , using, gravity and coagulation grasper for control of bleeding are important.

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Artikel online veröffentlicht:
14. April 2023