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Sequential endoscopic and surgical removal of giant rectal adenomas extending to the dentate line

Sequential endoscopic and surgical removal of giant rectal adenomas extending to the dentate line Techniques in Coloproctology (2018) 22:379–381 https://doi.org/10.1007/s10151-018-1794-1 TRICK OF THE TR ADE Sequential endoscopic and surgical removal of giant rectal adenomas extending to the dentate line 1 2 1 1 A. Rickenbacher  · P. Bauerfeind  · F. Rössler  · M. Turina Received: 5 February 2018 / Accepted: 5 May 2018 / Published online: 1 June 2018 © Springer International Publishing AG, part of Springer Nature 2018 Introduction adenomatous tissue. The submucosal defect reepithelializes and is checked for complete healing after 3 weeks (Fig. 1c) Large tubulovillous adenomas (TVA) in the low rectum that prior to the LAR/TME, which will then allow complete extend to or beyond the dentate line are a rare but challeng- removal of the remaining adenoma tissue (Fig. 2b). ing entity. Complete endoscopic resection is often not feasi- ble. In this situation, abdominoperineal resection with end Case 1 colostomy is the classic alternative to achieve an oncologi- cally safe resection. For benign disease however, this repre- A 63-year-old healthy female presented with rectal bleeding. sents an operation with a major long-term impact on quality The subsequent colonoscopy revealed a giant adenoma in the of life. In this report, we propose a hybrid technique using lower rectum with low-grade dysplasia. The tumor extended endoscopic submucosal dissection (ESD) of the lower part http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Techniques in Coloproctology Springer Journals

Sequential endoscopic and surgical removal of giant rectal adenomas extending to the dentate line

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References (5)

Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Surgery; Gastroenterology; Proctology; Abdominal Surgery; Colorectal Surgery
ISSN
1123-6337
eISSN
1128-045X
DOI
10.1007/s10151-018-1794-1
pmid
29858720
Publisher site
See Article on Publisher Site

Abstract

Techniques in Coloproctology (2018) 22:379–381 https://doi.org/10.1007/s10151-018-1794-1 TRICK OF THE TR ADE Sequential endoscopic and surgical removal of giant rectal adenomas extending to the dentate line 1 2 1 1 A. Rickenbacher  · P. Bauerfeind  · F. Rössler  · M. Turina Received: 5 February 2018 / Accepted: 5 May 2018 / Published online: 1 June 2018 © Springer International Publishing AG, part of Springer Nature 2018 Introduction adenomatous tissue. The submucosal defect reepithelializes and is checked for complete healing after 3 weeks (Fig. 1c) Large tubulovillous adenomas (TVA) in the low rectum that prior to the LAR/TME, which will then allow complete extend to or beyond the dentate line are a rare but challeng- removal of the remaining adenoma tissue (Fig. 2b). ing entity. Complete endoscopic resection is often not feasi- ble. In this situation, abdominoperineal resection with end Case 1 colostomy is the classic alternative to achieve an oncologi- cally safe resection. For benign disease however, this repre- A 63-year-old healthy female presented with rectal bleeding. sents an operation with a major long-term impact on quality The subsequent colonoscopy revealed a giant adenoma in the of life. In this report, we propose a hybrid technique using lower rectum with low-grade dysplasia. The tumor extended endoscopic submucosal dissection (ESD) of the lower part

Journal

Techniques in ColoproctologySpringer Journals

Published: Jun 1, 2018

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