Lesion: Ascending colon lesion thought to be cancer and biopsied extensively; biopsies revealed sessile serrated adenoma. Lesion occupies half of the circumference and extends over 2.5 folds. Patient preferred EMR to avoid surgery.
Preparation: Split dose preparation
Anesthesia: General anesthesia with endotracheal intubation
EMR: Piecemeal EMR was done; 9 injections and over 12 resections using 10 and 15 mm snares; 35 ml of saline with Methylene Blue injected. Hot biopsy snare avulsion was done for areas tethered to the based. APC was done to treat the edge.
Clip closure: Double Breast Clip Closure was successful. |