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. 2012 Sep;45(3):285-7.
doi: 10.5946/ce.2012.45.3.285. Epub 2012 Aug 22.

Indications, Knives, and Electric Current: What's the Best?

Bo-In Lee  1
Affiliations

Indications, Knives, and Electric Current: What's the Best?

Bo-In Lee. Clin Endosc. 2012 Sep.

Abstract

Endoscopic submucosal dissection (ESD) was developed to overcome the limitations of conventional endoscopic mucosal resection (EMR), and ESD has been also applied for large colorectal neoplasms. Since colorectal ESD is still associated with higher perforation rate, a longer procedure time, and increased technical difficulty, the indications should be strictly considered. Generally, colorectal tumors without deep submucosal invasion or minimal possibility of lymph node metastasis, for which en bloc resection using conventional EMR is difficult, are good candidates for colorectal ESD. The ideal knife for colorectal ESD should avoid making perforations but can make a clean cut of optimal depth at one time. The ideal current for ESD differs depending on the procedure used, the surgical devices used, the tissue to be dissected, and the operator's preference. Application of the optimal indications and improvements in the technical skill and surgical devices are required for easier and safer colorectal ESD.

Keywords: Colonoscopy; Colorectal neoplasms; Endoscopic submucosal dissection.

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Conflict of interest statement

The author has no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Electrosurgical knives for colorectal endoscopic submucosal dissection. Gray represents contact area.
See this image and copyright information in PMC

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