ASGE DDW Videos from Around the World | 2026-CIRCUMFERENTIAL ENDOSCOPIC SUBMUCOSAL DISSECTION OF A RECURRENT RECTAL CUFF ADENOMA IN AN IBD PATIENT

CIRCUMFERENTIAL ENDOSCOPIC SUBMUCOSAL DISSECTION OF A RECURRENT RECTAL CUFF ADENOMA IN AN IBD PATIENT

Video Transcription

Video Summary

A 73-year-old woman with ulcerative colitis and prior ileal pouch surgery developed a large recurrent rectal cuff adenoma after failed prior resections. Because surgery would likely require a permanent stoma, the team performed circumferential endoscopic submucosal dissection using a four-tunnel technique to overcome severe fibrosis and limited space near the anastomosis and dentate line. The lesion was removed en bloc without immediate complications. She healed well, had only a mild asymptomatic stricture, and remained recurrence-free at 18 months. This case shows ESD can be a safe, effective alternative to high-risk surgery for selected rectal cuff dysplasia in IBD patients.

Asset Subtitle

M. Hu, T. He, R. Chis, G.R. May, J.D. Mosko

Keywords

rectal cuff adenoma

endoscopic submucosal dissection

ulcerative colitis

ileal pouch surgery

fibrosis