结肠镜检查在直肠癌腺瘤EMR

                               
登录/注册后可看大图

Patient: Middle aged patient with multiple colon cancers in the past.
Lesion: Rectosigmoid polyp - notice the flat area suspicious for cancer (previous biopsies were benign).
Injection: Good lift after submucosal injection.
Snare: 10 mm stiff snare
Cut: Endocut Q 3-1-4. Did a little bit of cut before snare closure after applying it to the polyp with a few mm of margin followed by closure while applying the current.
Resection: Complete with no residual tissue and no bleeding or perforation.
APC: Edge treated with APC
Clip Closure: To prevent delayed complications
Pathology: Poorly differentiated adenocarcinoma within an adenoma; cut lateral and deep margin free of adenoma and cancer; no lymphovascular or neural invasion; cut margin to tumor distance: 0.1 mm.
Plan: Multidisciplinary surgical-oncology-radiotheraopy consult given the poorly differentiated cancer even though the resection was complete and there was no lymphovascular or neural invasion.