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Nemoto D, Hayashi Y, Utano K, et al. A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecation. Endosc Int Open. 2016;4(1):E93-5doi: 10.1055/s-0041-107902.
Nemoto, D., Hayashi, Y., Utano, K., Isohata, N., Endo, S., Lefor, A. K., Yamamoto, H., & Togashi, K. (2016). A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecation. Endoscopy international open, 4(1), E93-5. https://doi.org/10.1055/s-0041-107902
Nemoto, Daiki, et al. "A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecation." Endoscopy international open vol. 4,1 (2016): E93-5. doi: https://doi.org/10.1055/s-0041-107902
Nemoto D, Hayashi Y, Utano K, Isohata N, Endo S, Lefor AK, Yamamoto H, Togashi K. A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecation. Endosc Int Open. 2016 Jan;4(1):E93-5. doi: 10.1055/s-0041-107902. Epub 2016 Jan 08. PMID: 26793792; PMCID: PMC4713179.
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Endosc Int Open. 2016 Jan;4(1):E93-5. doi: 10.1055/s-0041-107902. Epub 2016 Jan 08.

A novel retrieval technique for large colorectal tumors resected by endoscopic submucosal dissection: tumor extraction by defecation.

Endoscopy international open

Daiki Nemoto, Yoshikazu Hayashi, Kenichi Utano, Noriyuki Isohata, Shungo Endo, Alan K Lefor, Hironori Yamamoto, Kazutomo Togashi

Affiliations

  1. Department of Coloproctology, Aizu Medical Center, Fukushima Medical University, Fukushima 969-3492 Japan.
  2. Department of Gastroenterology, Jichi Medical University, Tochigi 329-0498 Japan.
  3. Department of Surgery, Jichi Medical University, Tochigi 329-0498 Japan.

PMID: 26793792 PMCID: PMC4713179 DOI: 10.1055/s-0041-107902

Abstract

BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) has been developed to facilitate en bloc resection of large lesions. However, it is laborious to retrieve the large colorectal specimens. We propose a novel retrieval technique using a Valsalva maneuver, known as Tumor Extraction by Defecation (TED).

CASE SERIES: A total of nine lesions (median size 88 mm, maximum 225 mm; proximal colon three, rectum six) that could not be easily retrieved using net forceps were subsequently removed by TED. The rectum was filled with water through the colonoscope. The patient then strained to evacuate the specimen, facilitated by an almost straight anorectal angle. All specimens were retrieved without fragmentation, within minutes. Histology was assessed appropriately, including an adenoma in two and mucosal cancer in seven. All cut margins were verified to be negative. No adverse events occurred.

CONCLUSIONS: TED is a promising technique for retrieving large colorectal specimens after ESD.

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