By Toyooki Sonoda
This publication presents surgeons and gastroenterologists with cutting-edge options by way of complicated colonoscopy. Chapters introduce tools of removal polyps that weren't formerly amenable to colonoscopic snare polypectomy. complicated recommendations akin to closure of perforations and intestinal stenting are generally lined. The textual content keeps a powerful emphasis on surgical/endoscopic method. large dialogue on apparatus and ability acquisition can be lined. As many readers won't ever have obvious those advanced techniques sooner than, vast photos and videos are supplied. The authors supply advice, tips, and pitfalls that would aid the reader include those new strategies into their practice.
Advanced Colonoscopy: Polypectomy and past could be of significant price to any health care provider or gastroenterologist at present appearing colonoscopy and attracted to complicated techniques.
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Additional resources for Advanced Colonoscopy: Principles and Techniques Beyond Simple Polypectomy
The advantage of this technique is that it may reduce the risk of delayed perforation. A good candidate for this technique is a diminutive polyp. One randomized controlled study revealed similar post-procedural bleeding rates when cold snare polypectomy was compared to conventional snare polypectomy for the treatment of small colorectal polyps . 3 Endoscopic Mucosal Resection (EMR) 35 Precutting EMR Precutting EMR is a technique in which partial or circumferential mucosal incision is performed using electrocautery devices prior to snaring [13, 14].
Optimal polypectomy technique demands a clean colon, and the presence of stool makes the consequences of perforation more dire. The state of the rest of the colon is also important. A proximal cancer is a contraindication to removal of a distal polyp. If there are multiple polyps, restrict resection to one area of the colon and leave other areas for another day, so that post-polypectomy bleeding can only be coming from one site. In summary, removal of a difficult lesion should only be attempted in a good-risk patient with a clean colon that is free of more advanced lesions.
1994;89(3):334–8. 8. Uraoka T, Fujii T, Saito Y, Sumiyoshi T, Emura F, Bhandari P, et al. Effectiveness of glycerol as a submucosal injection for EMR. Gastrointest Endosc. 2005;61(6):736–40. 9. Fujishiro M, Yahagi N, Kashimura K, Mizushima Y, Oka M, Enomoto S, et al. Comparison of various submucosal injection solutions for maintaining mucosal elevation during endoscopic mucosal resection. Endoscopy. 2004;36(7):579–83. 10. Endoscopic Classification Review Group. Update on the paris classification of superficial neoplastic lesions in the digestive tract.
Advanced Colonoscopy: Principles and Techniques Beyond Simple Polypectomy by Toyooki Sonoda