结肠镜检查-升结肠EMR切除之前失败后

Patient: Middle aged patient
Lesion: Ascending colon flat lesion; prior extensive biopsies resulted in scarring.
General anesthesia with endotracheal intubation
EMR: Piecemeal EMR + Hot biopsy avulsion + APC of base + clip closure
The anal side of the lesion was tethered; injection on the cecal side resulted in a good lift, but the lesion was anchored on the anal side. 10 mm stiff snare resection of the cecal side possible; anal side required hot biopsy avulsion; bleeding required hemostasis; the base was treated with APC. Clip closure done (see next movie). Took 2 hours for the procedure.

                               
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