Endoscopic ampullectomy of a large neuroendocrine tumor using underwater EMR technique

Post written by Anand R. Kumar, MPH, MD, from the Division of Gastroenterology, Thomas Jefferson University, Philadelphia, Pennsylvania. A young man presented with an incidental 35-mm ampullary neuroendocrine tumor detected on upper endoscopy. We chose to do an underwater ampullectomy and obtained negative margins. Endoscopic ampullectomy is an advanced procedure with variable techniques. The underwater …

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Impact of en bloc resection on long-term outcomes after EMR

Post written by Mayenaaz Sidhu, MBBS, from the Department of Gastroenterology and Hepatology, Westmead Hospital, and Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia. The focus of this study was to assess long-term outcomes of sized-matched laterally spreading colorectal lesions (LSL) resected en bloc (e-EMR) as compared to piece-meal resection (p-EMR). …

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Underwater EMR of a colonic adenoma surrounded by diverticula

Post written by Satoki Shichijo, MD, PhD, from the Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan. A 15-mm diameter laterally spreading tumor surrounded by multiple diverticula was pointed out at the ascending colon. The lesion was considered to be an indication for endoscopic resection. However, conventional endoscopic mucosal resection (EMR) of the …

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Editor’s Choice: Trends in EMR for nonmalignant colorectal polyps in the United States

GIE Associate Editor, Dr. Lyndon Hernandez, MD, MPH, highlights this article from the January issue “Trends in EMR for nonmalignant colorectal polyps in the United States” by Jessica X. Yu, MD, MS, et al.  Using a large health insurance claims database, the authors observed an increase in the performance of EMR for colorectal lesions. However, …

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Wide-field underwater EMR followed by line-assisted complete closure for a large duodenal adenoma

Post written by Hiroko Nakahira, MD, from the Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan. Underwater endoscopic mucosal resection (EMR) was performed for a large duodenal adenoma in a patient with familial adenomatous polyposis, and the mucosal defect after underwater EMR was closed with line-assisted complete closure technique. Endoscopic mucosal resection for …

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Optimizing histopathologic evaluation of EMR specimens of Barrett’s esophagus–related neoplasia

Post written by Anouk Overwater, MD, from the Department of Gastroenterology and Hepatology, St Antonius Hospital, Nieuwegein, and the Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. The main question of this study is which specimen handling method results in an optimal histopathological evaluation of endoscopic resection specimens of …

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Usefulness and safety of colorectal precutting EMR and hybrid ESD for sessile serrated polyps

Post written by Yuzuru Tamaru, MD, PhD, from the Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure, Japan. In this report, we present 2 cases of precutting endoscopic mucosal resection (EMR)/hybrid endoscopic submucosal dissection (ESD) with a circumferential incision and partial dissection followed by snare resection via SOUTEN. We also …

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Outcome of EMR in Barrett’s esophagus determined by systematic quantification of epithelial glands using VLE

Post written by Amrit K. Kamboj, MD, and Cadman L. Leggett, MD, from the Department of Internal Medicine and Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA. Volumetric laser endomicroscopy (VLE) is an advanced imaging modality that uses optical coherence tomography to capture real-time, high-resolution, cross-sectional images of the esophagus. Epithelial glands are …

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Precutting EMR with full or partial circumferential incision with a snare tip

Post written by Naohisa Yoshida, MD, PhD, from the Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan. We herein introduce 2 cases in which precutting EMR with a snare was performed. The first case was a IIa+IIc lesion 10 mm in size on the sigmoid …

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False sense of security: a case of retroperitoneal perforation after colonic EMR

Post written by Leonardo Zorron Cheng Tao Pu, MD, MSc, FBCS, FASGE, from the Department of Gastroenterology, Lyell McEwin Hospital, Adelaide, Australia. In our video a 61-year-old woman was submitted to piecemeal EMR for a large lateral spreading tumor at the recto-sigmoid junction. After the second piece was resected, we noted a suspicious area of …

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