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Endoscopic Mucosal Resection of Colorectal Lesions

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Book cover Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy

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Abstract

Endoscopic mucosal resection (EMR) is a safe and effective treatment for large laterally spreading colorectal lesions. The safety and efficacy of EMR follows a key anatomical principle: complete tissue resection of a mucosal lesion above a submucosal fluid cushion to avoid injury to the deeper mural layers. The majority of polyps encountered have low risk of submucosal invasion and are suitably treated by EMR; however, appropriate lesion selection is fundamental to satisfactory patient outcomes. This chapter discusses endoscopic assessment of large colonic polyps, technical aspects of EMR, techniques to manage procedural related complications, and post-procedural follow-up of patients.

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Abbreviations

CAST:

cold forceps avulsion with adjuvant snare-tip soft coagulation

CE:

chromoendoscopy

CRC:

colorectal cancer

CSPEB:

clinically significant post-endoscopic bleeding

DMI:

deep mural injury

EEI:

enhanced endoscopic imaging

EMR:

endoscopic mucosal resection

ESD:

endoscopic submucosal dissection

GIT:

gastrointestinal tract

ICV:

ileocecal valve

LSL:

laterally spreading lesion

MP:

muscularis propria

PPES:

post-polypectomy electrocoagulation syndrome

SMF:

submucosal fibrosis

SMI:

submucosal invasion

STSC:

snare tip soft coagulation

TSC:

topical submucosal chromoendoscopy

TTS:

through the scope

UEMR:

underwater EMR

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Author information

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Perth, WA, Australia

    Michael X. Ma

  2. Department of Medicine, Midland St John of God Public and Private Hospitals, Perth, WA, Australia

    Michael X. Ma

  3. Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, NSW, Australia

    Michael J. Bourke

  4. University of Sydney, Sydney, NSW, Australia

    Michael J. Bourke

Authors
  1. Michael X. Ma
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  2. Michael J. Bourke
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Corresponding author

Correspondence to Michael J. Bourke .

Editor information

Editors and Affiliations

  1. Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, MILANO, Milano, Italy

    Pier Alberto Testoni

  2. Digestive Diseases Center, Showa University Hospital, Tokyo, Japan

    Haruhiro Inoue

  3. Div. of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA

    Michael B. Wallace

Section Editor information

  1. Cancer Center, Mayo Clinic, Jacksonville, FL, USA

    Michael B. Wallace

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Ma, M.X., Bourke, M.J. (2020). Endoscopic Mucosal Resection of Colorectal Lesions. In: Testoni, P.A., Inoue, H., Wallace, M.B. (eds) Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-29964-4_18-1

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  • DOI: https://doi.org/10.1007/978-3-030-29964-4_18-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-29964-4

  • Online ISBN: 978-3-030-29964-4

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