结肠直肠肿瘤EMR LST G

Patient: Middle aged patient with a 7-8 cm 3/4 circumferential LST Granular tumor. Patient wanted to avoid surgery if this could be done endoscopically.
Preparation: Split dose preparation
Anesthesia: Propofol sedation converted to general anesthesia as he started coughing after 1/3 cut for a stable field.
Solution: Normal saline (1 liter bag) mixed with 10 ml of 1:10,000 epinephrine and few drops of Methylene Blue
Injection: Multiple injections; 18 injections; 55 ml injected
Snare resection: 10 and 15 mm stiff snare piecemeal resections; 43 resections.
Total procedure time: 3 hours
Pathology: Tubulovillous adenoma with HGD

                               
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