Brief Article
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World J Gastroenterol. Nov 21, 2010; 16(43): 5462-5466
Published online Nov 21, 2010. doi: 10.3748/wjg.v16.i43.5462
Traction-assisted endoscopic mucosal resection for polypectomy in the large intestine
Bernhard Dauser, Thomas Winkler, Behrooz Salehi, Stefan Riss, Franz Beer, Friedrich Herbst
Bernhard Dauser, Thomas Winkler, Behrooz Salehi, Friedrich Herbst, Department of Surgery, St. John of God Hospital, 1020 Vienna, Austria
Stefan Riss, Department of Surgery, Medical University of Vienna, 1090 Vienna, Austria
Franz Beer, Kerjaschki Laboratory of Pathology, 1160 Vienna, Austria
Author contributions: Dauser B, Winkler T, Salehi B, Riss S, Beer F and Herbst F contributed to the conception and design of the study, and acquisition and interpretation of data; all authors revised the article and approved the final version.
Correspondence to: Bernhard Dauser, MD, Department of Surgery, St. John of God Hospital, Johannes von Gott Platz 1, A-1020 Vienna, Austria. bernhard.dauser@gmail.com
Telephone: +43-1-211215098 Fax: +43-1-211213257
Received: May 28, 2010
Revised: July 6, 2010
Accepted: July 13, 2010
Published online: November 21, 2010
Abstract

AIM: To evaluate if traction-assisted endoscopic mucosal resection (TA-EMR) is feasible and if it enables en bloc resection of colorectal lesions.

METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

Keywords: Traction-assisted; Endoscopic mucosal resection; Colon polyp; Colonoscopy