Endoscopy 2019; 51(04): S89
DOI: 10.1055/s-0039-1681432
ESGE Days 2019 oral presentations
Friday, April 5, 2019 17:00 – 18:30: Video lower GI 2 South Hall 1A
Georg Thieme Verlag KG Stuttgart · New York

ESD OF LST-NG TYPE WITH UNDERLYING SUBMUCOSAL TUMOR

A Herreros de Tejada
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
D De Frutos
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
J Santiago
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
G Vazquez
2   Pathology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
I Gonzalez-Partida
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
B Agudo
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
M Gonzalez-Haba
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
A Garrido
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
P Matallanos
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
E Blazquez
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
M Bote
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
M Sol Delgado
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
G Pilar
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
,
JL Calleja
1   Gastroenterology, Puerta de Hierro – Majadahonda University Hospital, Majadahonda, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

 
 

    Introduction:

    Colonic lipomas are benign submucosal lesions which exceptionally may associate with colonic neoplasia or adenoma. LST-NG pseudo-depressed type over 2 cm commonly require en-bloc resection with ESD or other alternative techniques.

    Procedure:

    A 69 y/o woman was diagnosed with an 40 mm LST-NG PD in ascending colon with no apparent associated lesions, and thus scheduled for ESD. Initial approach to the lesion showed a sessile pseudo-depressed area in proximal section of the lesion. Colonic diverticulum was ruled out after submucosal injection, and ESD was initiated. A pediatric colonoscope (PCF-H190L; Olympus Co.) and Flush Knifeâ BT 1.5 mm (Fujifilm Co.) were used.

    Results:

    A complete en-bloc resection of the LST-NG lesion together with underlying submucosal yellowish tumor was achieved in a single specimen of 60 × 40 mm. Preventive closure of the mucosal defect was completed using TTS clips. The patient was discharged 48h later. Pathology examination showed 40 × 31 mm tubular adenoma with free lateral and deep margins (R0), including an underlying 20 × 15 mm lipoma.

    Conclusions:

    Underlying lipoma in LST lesions may not be noticed, or it can mimic a diverticulum. Although this circumstance makes ESD more demanding, this technique allows safe and successful en-bloc removal of such complex lesions.


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