ASGE DDW Videos from Around the World | 2025-UNDERWATER EN BLOC R0 INTERMUSCULAR DISSECTION OF A T1B RECTAL ADENOCARCINOMA IN A PATIENT WITH DECOMPENSATED CIRRHOSIS WITH PROPHYLACTIC USE OF RECOMBINANT FACTOR VII

UNDERWATER EN BLOC R0 INTERMUSCULAR DISSECTION OF A T1B RECTAL ADENOCARCINOMA IN A PATIENT WITH DECOMPENSATED CIRRHOSIS WITH PROPHYLACTIC USE OF RECOMBINANT FACTOR VII

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Video Transcription

Video Summary

The transcript describes a case of intermuscular dissection to treat a 60-year-old patient with T1b rectal adenocarcinoma and decompensated cirrhosis using recombinant factor VII due to bleeding risks. Traditional endoscopic submucosal dissection (ESD) was adapted for this complex case, utilizing an underwater approach for improved visualization and vessel management. This method allows for R0 resection without affecting the possibility of future surgery. Recombinant factor VII was used prophylactically, marking a novel approach for this scenario. Results indicate a high success rate with no major complications, supporting this technique as an alternative to more invasive procedures.

Asset Subtitle

Derek Gindi

Meta Tag

Concept Endoscopic Intermuscular Dissection

Concept Rectal Adenocarcinoma

Concept Submucosal Invasion

Concept T1b Cancer

Concept R0 resection

Keywords

intermuscular dissection

rectal adenocarcinoma

recombinant factor VII

underwater approach

R0 resection

Endoscopic Intermuscular Dissection

Rectal Adenocarcinoma

Submucosal Invasion

T1b Cancer

R0 resection