ASGE/JGES Advanced ESD (Live and Virtual)| July 14-15 2023-7-15-23 Bring Your Case 2

Video Transcription

Video Summary

In this video, Mayu Tanabe from Showa University Koto Teosho Hospital discusses a case of chronic ESD, specifically a protruding lesion located in the sigmoid colon. Due to the patient's old age and comorbidities, the ESD procedure was challenging, with findings of muscle layer retraction making it difficult to identify the incision line. Gradually, the correct incision line was determined, but unexpected bleeding occurred near the end of the procedure. The bleeding point was located using RDI, and after achieving hemostasis, the perforation was closed using clips. Although the resection of the lesion was incomplete, the patient did not experience postoperative complications. The final pathological diagnosis confirmed the lesion as PT1B with negative resection margins and no lymphovascular invasion. The video also includes a discussion among the participants regarding the challenges of muscle traction and severe fibrosis in ESD procedures and techniques to address them. No credits were provided.

Keywords

chronic ESD

protruding lesion

sigmoid colon

muscle layer retraction

bleeding point