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Mastering Endoscopic Resection: A Step-by-Step Guide to Removing LSTs in the Ascending Colon
Manage episode 433015456 series 3591778
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Episode Overview
- Discussion on the endoscopic resection of a laterally spreading tumor (LST) in the ascending colon.
- Examination of a flat polypoid lesion larger than 10 mm, classified as an LST.
Key Steps in Resection Planning
- Determining the Lesion's Location: Found between two folds.
- Analyzing Morphology: Identified as LST-granular.
- Surface Analysis: Using high-definition white light and narrow-band imaging, revealing a regular, cerebroid mucosal pit pattern without ulcers or depressions (Kudo IIIL).
- Maintaining Visibility: Employing a "suction" mark technique to keep track of the polyp.
Resection Techniques
- Comparison of "cold snare" and "hot snare" techniques.
- Preference for endoscopic resection using interventional chromoendoscopy.
Interventional Chromoendoscopy
- Submucosal injection with a blue colorant to differentiate tissue types.
- The concept of using colorings to guide therapeutic interventions.
Resection Process
- Using a snare to estimate lesion size and achieve complete entrapment.
- Achieving an endoscopic R0 resection by applying electrosurgical current.
Links:
https://www.thepracticingendoscopist.com/p/endoscopic-resection-of-lst-in-ascending-colon
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