Clin Endosc.  2013 Sep;46(5):492-494.

Tips and Tricks for Better Endoscopic Treatment of Colorectal Tumors: Usefulness of Cap and Band in Colorectal Endoscopic Mucosal Resection

• Park SJ

Abstract

Endoscopic mucosal resection (EMR) is an endoscopic alternative to surgical resection of mucosal and submucosal neoplastic lesions. Prior to the development of knives, EMR could be performed with accessories to elevate the lesion. After the development of various knives, en bloc resection was possible without other accessories. So, recently, simple snaring without suction or endoscopic submucosal dissection using knife in the epithelial lesions such as adenoma or early mucosal cancer has been performed. However, for easy and complete resection of subepithelial lesions such as carcinoid tumor, a few accessories are needed. Complete resection of rectal carcinoid tumors is difficult to achieve with conventional endoscopic resection techniques because these tumors often extend into the submucosa. The rate of positive resection margin for tumor is lower in the group of EMR using a cap (EMR-C) or EMR with a ligation device (EMR-L) than conventional EMR group. EMR-C and EMR-L (or endoscopic submucosal resection with a ligation device) may be a superior method to conventional EMR for removing small rectal carcinoid tumors.

Keyword

Endoscopic mucosal resection; Cap; Band ligation

MeSH Terms

Adenoma
Carcinoid Tumor
Ligation
SNARE Proteins
Suction
SNARE Proteins

Figure

• 

  Fig. 1 (A) At 10 cm from anal verge, 6 mm sized, round, yellowish, elevated lesion with normal mucosa was noted. (B) Tissue is banded using an esophageal variceal banding device and (C) then snared off in the standard fashion. (D) The lesion was removed.

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