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CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(03): E146-E150
DOI: 10.1055/s-0042-122965
Case report
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

First reported case of per anal endoscopic myectomy (PAEM): A novel endoscopic technique for resection of lesions with severe fibrosis in the rectum

David Ozzie Rahni
1   Brown University/Rhode Island Hospital, Rhode Island Hospital, Providence, United States
,
Takashi Toyonaga
2   Department of Endoscopy, Kobe University Hospital, Kobe, Japan
3   Department of Endoscopy, Kishiwada Tokushukai Hospital, Kishiwada, Japan
,
Yoshiko Ohara
4   Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
,
Francesco Lombardo
5   Emergency Endoscopy Unit, Borgo Trento Hospital, Verona, Italy
,
Shinichi Baba
3   Department of Endoscopy, Kishiwada Tokushukai Hospital, Kishiwada, Japan
,
Hiroshi Takihara
3   Department of Endoscopy, Kishiwada Tokushukai Hospital, Kishiwada, Japan
,
Shinwa Tanaka
4   Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
,
Fumiaki Kawara
4   Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
,
Takeshi Azuma
4   Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
› Author Affiliations
Further Information

Publication History

submitted 28 June 2016

accepted after revision 04 October 2016

Publication Date:
06 March 2017 (online)

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Endoscopy International Open – recently publishedEndoscopy 2017; 49(04): 407-408
DOI: 10.1055/s-0043-104129

Background and study aims A 54-year-old man was diagnosed with a rectal tumor extending through the submucosal layer. The patient refused surgery and therefore endoscopic submucosal dissection (ESD) was pursued. The lesion exhibited the muscle retraction sign. After dissecting circumferentially around the fibrotic area by double tunneling method, a myotomy was performed through the internal circular muscle layer, creating a plane of dissection between the internal circular muscle layer and the external longitudinal muscle layer, and a myectomy was completed.

The pathologic specimen verified T1b grade 1 sprouting adenocarcinoma with 4350 µm invasion into the submucosa with negative resection margins.

 

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