结肠镜检查-升结肠EMR

Patient: Middle aged patient; heavy set; 9 hours away from referral center
Lesion: Ascending colon LST-G; no endoscopic features of cancer
Anesthesia: General anesthesia with endotracheal intubation
EMR: Piecemeal EMR (2 pieces) + APC + Clip closure
Injection: Cecal side injection and bring the lesion forwards
Resection: 20 mm stiff snare; 2 piece resection; resection took several seconds.
Resection base: Blue with brown tinge (sm fibers seen); clean edge; few vessels - treated with APC and hemostatic forceps.
Clip Closure: At 1 mm interval as he is quite far from the referral center.
Pathology: Tubular adenoma with HGD.

                               
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