Four cases of a laterally spreading tumor (LST) of colon treated by a single piece using submucosal dissection EMR with electro-surgical snare (thin type)

Abstract

Submucosal dissection EMR using an electro-surgical snare was performed for four cases of an LST.
The age of the patients was ranged from 58 to 69 year-old. The size of the tumors was 20 to 43 mm (mean 34.8mm) in diameter and three tumors were on the colonic fold. Macroscopic type was two granular-type LSTs and two non granular-type LSTs. Submucosal dissection EMR was performed for these cases. Because strip biopsy was associated with a high risk of piece-meal resection due to the size and the location of the tumors. The tumors were successfully resected by a single piece. Histological examination showed one focal cancer in tubulovillous adenoma (m, ly0, v0) , three tubular adenoma with moderate to severe atypia. The margins of the specimens were free of tumor invasion along their circumferences. Thus the pathological findings fulfilled the criteria for curative EMR. This procedure seems to be useful for a single piece resection of relatively large mucosal colorectal tumors, even when they are located on the colonic fold.