Hayashi Yoshikazu, Okada Masahiro, Morikawa Takaaki, Nomura Tatsuma, Fukuda Hisashi, Takezawa Takahito, Lefor Alan Kawarai, Yamamoto Hironori
Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.
Department of Gastroenterology, ShinOyama City Hospital, Oyama, Japan.
Clin Endosc. 2021 May;54(3):436-440. doi: 10.5946/ce.2020.168. Epub 2020 Nov 6.
Superficial colonic neoplasms sometimes extend into a diverticulum. Conventional endoscopic mucosal resection of these lesions is considered challenging because colonic diverticula do not have a muscularis propria and are deeply inverted. Even if the solution is carefully injected below the mucosa at the bottom of the diverticulum, the mucosa is rarely elevated from the diverticular orifice, and it is usually just narrowed. Although endoscopic submucosal dissection or full-thickness resection with an over-the-scope clip device enables the complete resection of these lesions, it is still challenging, time consuming and expensive. Underwater endoscopic mucosal resection without submucosal injection (UEMR) is an innovative technique enabling en bloc resection of superficial colon lesions. We report three patients with colon adenomas extending into a diverticulum treated with successful UEMR. UEMR enabled rapid and safe en bloc resection of colon lesions extending into a diverticulum.
浅表性结肠肿瘤有时会延伸至憩室。由于结肠憩室没有固有肌层且深陷其中，对这些病变进行传统的内镜黏膜切除术被认为具有挑战性。即使在憩室底部黏膜下小心注射溶液，黏膜也很少能从憩室开口处隆起，通常只是变窄。尽管内镜黏膜下剥离术或使用套扎装置进行全层切除术能够完整切除这些病变，但仍然具有挑战性、耗时且昂贵。水下内镜黏膜切除术（UEMR）是一种无需黏膜下注射的创新技术，能够整块切除浅表性结肠病变。我们报告了3例结肠腺瘤延伸至憩室的患者，他们接受UEMR治疗均获成功。UEMR能够快速、安全地整块切除延伸至憩室的结肠病变。
