Colon Cancer Prevention: EMR of Flat Lesion – SSA

Description:

Colon cancer prevention series: we would like to share with you endoscopic mucosal resection of a flat lesion in the cecum. Here is a 62 year old man who was recently diagnosed with prostrate cancer. He was referred to us for colonoscopy. He had two large sessile serrated adenomas removed earlier. He came in for removal of additional lesions. In this video, we would like to highlight cap assisted endoscopy for better views and cecal EMR inside a fold. Here we reached the cecum – a fairly good view of the cecum, looks normal. However, on examination behind a fold with the help of a cap revealed a large flat IIB lesion, better seen with the help of the cap as you open up the folds. This was removed with endoscopic submucosal resection in a piecemeal fashion, followed argon plasma coagulation of the edges to prevent recurrence and clip closure of the defect to prevent delayed complications. The pathology revealed a sessile serrated adenoma.

Contributed By:

Gottumukkala S. Raju, MD, MD Anderson Cancer Center

Liben Mahometano, MD Anderson Cancer Center

Asif Rashid, MD, PhD, MD Anderson Cancer Center

Patrick Lynch, MD, MD Anderson Cancer Center