Department of Surgery, St. John of God Hospital, Johannes von Gott Platz 1, A-1020 Vienna, Austria.
World J Gastroenterol. 2010 Nov 21;16(43):5462-6. doi: 10.3748/wjg.v16.i43.5462.
To evaluate if traction-assisted endoscopic mucosal resection (TA-EMR) is feasible and if it enables en bloc resection of colorectal lesions.
Seven patients with a total of 12 colorectal adenomas were prospectively enrolled. All lesions were removed by TA-EMR: one hemostatic clip tied to a white silk suture was applied to the base of the lesion to allow traction through the working channel of the colonoscope. A conventional polypectomy snare was mounted over the suture and the lesion was pulled into the snare and resected in one piece.
All 12 lesions (nine sessile) were resected en bloc with free lateral and vertical margins by using this novel technique, including five lesions (5/12, 41.6%) in less-accessible positions, where TA-EMR enabled complete visualization of the base before resection. Mean longest lesion and specimen sizes were 9 mm (range: 6-25 mm) and 11 mm in diameter (range: 7-17 mm), respectively. No serious procedure-related complications were observed.
TA-EMR through the endoscope using a hemostatic clip and suture material is technically feasible. Visualization of colorectal lesions in less-accessible locations can be improved.
评估经内镜黏膜下牵引切除术（TA-EMR）是否可行，以及是否能整块切除结直肠病变。
前瞻性纳入 7 例共 12 例结直肠腺瘤患者。所有病变均通过 TA-EMR 切除：在病变底部系一条止血夹上的白色丝线，以便通过结肠镜工作通道进行牵引。将传统的息肉切除术圈套器套在丝线上，将病变拉入圈套器中并整块切除。
所有 12 个病变（9 个无蒂）均通过这项新技术整块切除，且边缘游离，无侧向和垂直切缘残留，包括 5 个（5/12，41.6%）位置较难到达的病变，TA-EMR 可在切除前充分观察到病变基底。最长病变和标本的长度分别为 9 毫米（范围：6-25 毫米）和 11 毫米（范围：7-17 毫米）。未观察到与操作相关的严重并发症。
通过内镜使用止血夹和缝线材料进行 TA-EMR 在技术上是可行的，可改善对较难到达部位的结直肠病变的可视化效果。
