Double-tunneling butterfly method for endoscopic submucosal dissection of extensive rectal neoplasms.

ABSTRACT:

Background and aims

Endoscopic submucosal dissection (ESD) is the preferred technique for en bloc resection of superficial colorectal neoplasms. Resection of extensive lesions with ESD can be challenging, owing to loss of orientation in the submucosal space. In this case series, we describe the double-tunneling (DoT) butterfly method for ESD of extensive rectal neoplasms.

Methods

The key feature of the DoT butterfly method is the creation of 2 tunnels that are transformed into bilateral flaps, leaving a submucosal septum between them.

Results

Four rectal neoplasms measuring (maximum diameter) 7 cm, 8 cm, 9 cm, and 18 cm, respectively, were resected in 4 patients by use of the DoT butterfly method. The lesions included recurrent adenoma (n = 1) and dysplasia (n = 1) in

SUBMITTER: Stasinos I 

PROVIDER: S-EPMC7004922 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature