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Michael B. Wallace - One of the best experts on this subject based on the ideXlab platform.

  • colorectal Endoscopic Mucosal Resection emr
    Best Practice & Research in Clinical Gastroenterology, 2017
    Co-Authors: Pujan Kandel, Michael B. Wallace
    Abstract:

    Colonoscopy has the benefit of detecting and treating precancerous adenomatous polyps and thus reduces mortality associated with CRC. Screening colonoscopy is the keystone for prevention of colorectal cancer. Over the last 20 years there has been increased in the management of large colorectal polyps from surgery to Endoscopic removal techniques which is less invasive. Traditionally surgical Resection was the treatment of choice for many years for larger polyps but colectomy poses significant morbidity of 14-46% and mortality of up to 7%. There are several advantages of Endoscopic Resection technique over surgery; it is less invasive, less expensive, has rapid recovery, and preserves the normal gut functions. In addition patient satisfaction and efficacy of EMR is higher with minor complications. Thus, this has facilitated the development of advanced Resection technique for the treatment of large colorectal polyps called as Endoscopic Mucosal Resection (EMR).

  • Colonic Endoscopic Mucosal Resection of large polyps: Is it safe in the very elderly?
    Digestive and Liver Disease, 2014
    Co-Authors: Victoria Gomez, Michael B. Wallace, Ronald G. Racho, Timothy A. Woodward, Massimo Raimondo, Ernest P. Bouras, Frank Lukens
    Abstract:

    Abstract Background Outcomes on colon Endoscopic Mucosal Resection in the very elderly patient population are unknown. Aims Aims of this study were to evaluate the outcomes and safety of colon Endoscopic Mucosal Resection in this target population. Methods Observational, retrospective study of patients ≥80 years of age that underwent colon Endoscopic Mucosal Resection ≥2 cm. Demographics, American Society of Anesthesiologists classification, procedural data, and surgical treatment data were collected. Results One-hundred-and-thirty-one colon Endoscopic Mucosal Resections were performed on 99 patients ≥80 years of age with a mean age of 84. The majority of American Society of Anesthesiologists class was II. Mean lesion size was 3.3 cm (range, 2–12.5 cm), more procedures were performed in the right colon and adenoma/tubulovillous adenoma was the most common pathology. En bloc Resection was performed on 26.7% of polyps (N = 35). Eight procedure-related adverse events (8/131, 6.1%) occurred. No anaesthesia related adverse events or deaths occurred. Six patients required a colonic operation, and overall, 94% of the patient cohort evaded a colon operation. Conclusions Colon Endoscopic Mucosal Resection in very elderly patients can be performed at experienced endoscopy centres with a low rate of complications and offers these patients a non-surgical option of management of colorectal lesions.

  • Endoscopic Mucosal Resection: Therapy for Early Colorectal Cancer
    Journal of Cancer Therapy, 2013
    Co-Authors: Kondal R. Kyanam Kabir Baig, Michael B. Wallace
    Abstract:

    We review the use of Endoscopic Mucosal Resection in the treatment of early colorectal cancer. Newer Endoscopic imaging modalities have lead to earlier detection of advanced lesions thus enabling Endoscopic curative therapy of lesions that would otherwise need surgery. Early outcomes data suggest promising results. But further long term prospective studies are needed.

  • predictors of complete Endoscopic Mucosal Resection of flat and depressed gastrointestinal neoplasia of the colon
    The American Journal of Gastroenterology, 2012
    Co-Authors: Timothy A. Woodward, Massimo Raimondo, Michael G Heckman, Patrick W Cleveland, Silvio W De Melo, Michael B. Wallace
    Abstract:

    Predictors of Complete Endoscopic Mucosal Resection of Flat and Depressed Gastrointestinal Neoplasia of the Colon

Eui Gon Youk - One of the best experts on this subject based on the ideXlab platform.

Takuji Gotoda - One of the best experts on this subject based on the ideXlab platform.

  • Endoscopic Mucosal Resection using a cap
    Techniques in Gastrointestinal Endoscopy, 2020
    Co-Authors: Tonya Kaltenbach, Hisatomo Ikehara, Takuji Gotoda
    Abstract:

    Endoscopic Mucosal Resection (EMR) is a technique used to locally excise for cure of Mucosal lesions and early gastrointestinal cancers that carry minimal risk of nodal metastasis. This review will describe the indications, techniques, and complications of the EMR using a cap (EMR-C) method.

  • Application of Endoscopic Mucosal Resection for hypopharyngeal cancer
    Digestive Endoscopy, 2020
    Co-Authors: Mitsuhiro Fujishiro, Takuji Gotoda, Hajime Yamaguchi, Yukihiro Nakanishi, Waichiro Ooyama, Hiroshi Watanabe, Takahiro Kozu, Hitoshi Kondo, Daizo Saito
    Abstract:

    Endoscopic Mucosal Resection (EMR) was applied in an 80-year-old Japanese man with stage I hypopharyngeal cancer because he refused further radical therapy after esophagogastrectomy for gastric and esophageal cancers. Although EMR was successfully performed without complications, histopathologic investigation revealed cancer-positive lateral margins. Furthermore, another biopsy from the right aryepiglottic fold yielded a diagnosis of laryngeal cancer. Radiation therapy was ultimately performed because of the possibility of residual tumor and coexistent laryngeal cancer. Endoscopic Mucosal Resection as a curative treatment for hypopharyngeal cancer is associated with several problems that must be resolved before general application is feasible. However, the present case, at least, shows the possibility of using EMR as a diagnostic procedure and as a less invasive palliative treatment.

  • Endoscopic Mucosal Resection for early cancers of the upper gastrointestinal tract
    Journal of Clinical Oncology, 2005
    Co-Authors: Roy Soetikno, Tonya Kaltenbach, Takuji Gotoda
    Abstract:

    The purpose of this literature review is to examine recent advances in technique and technology of Endoscopic Mucosal Resection of superficial early cancers of the upper gastrointestinal tract. Endoscopic Mucosal Resection (EMR) of superficial early cancers of the upper gastrointestinal tract is standard technique in Japan and is increasingly used in Western countries. Newer techniques of EMR allow removal of larger lesions en-bloc. These minimally invasive techniques, when applied correctly, allow safe and efficacious treatment in situations that would otherwise require major surgery. Through the establishment of long-term outcomes data, standardization of Endoscopic and pathologic reporting, and newer EMR technology and techniques, the future treatment of early cancers in the upper gastrointestinal tract may be achieved primarily through the endoscope.

  • Endoscopic Mucosal Resection
    Endoscopy, 2001
    Co-Authors: B J Rembacken, Takuji Gotoda, Takahiro Fujii, A T R Axon
    Abstract:

    We are now finding more malignancies in their early stages than previously. Attempts to ablate these lesions are difficult and do not provide the histological information required to decide on further treatment. Surgery is difficult to justify, as only a minority of lesions are associated with lymph node metastases and lesions may not become clinically relevant within the lifetime of an elderly patient. Endoscopic Mucosal Resection allows cancers to be resected at minimal cost, morbidity and mortality. It is also the most reliable investigation when assessing lesions which are suspicious for containing early cancer. After Endoscopic removal, histological assessment of depth of penetration and a search for invasion into lymphatics or venules allows the risk of microscopic lymph node metastases to be predicted. The risk of developing metastatic disease can then be balanced against the risks of surgery in view of the patient's age and health.

Charles J. Kahi - One of the best experts on this subject based on the ideXlab platform.

A J Lobo - One of the best experts on this subject based on the ideXlab platform.

  • colonoscopic Resection of lateral spreading tumours a prospective analysis of Endoscopic Mucosal Resection
    Gut, 2004
    Co-Authors: David P Hurlstone, David S Sanders, Simon S Cross, I J Adam, Andrew J Shorthouse, S R Brown, K Drew, A J Lobo
    Abstract:

    Background: Lateral spreading tumours are superficial spreading neoplasms now increasingly diagnosed using chromoscopic colonoscopy. The clinicopathological features and safety of Endoscopic Mucosal Resection for lateral spreading tumours (G-type “aggregate” and F-type “flat”) has yet to be clarified in Western cohorts. Methods: Eighty two patients underwent magnification chromoscopic colonoscopy using the Olympus CF240Z by a single endoscopist. All patients had received a previous colonoscopy where an Endoscopic diagnosis of lateral spreading tumour was made. All lesions were examined initially using indigo carmine chromoscopy to delineate contour followed by crystal violet for magnification crypt pattern analysis. A 20 MHz “mini probe” ultrasound was used if T2 disease was suspected. Following Endoscopic Mucosal Resection, patients were followed up at 3, 6, 12, and 24 months using total colonoscopy. Results: Eighty two lateral spreading tumours were diagnosed in 80 patients (32% (26/82) F-type and 68% (56/82) G-type). G-type lesions were larger than F-type (G-type mean 42 (SD 14) mm v F-type 24 (6.4) mm; p<0.01). F-type lesions were more common in the right colon (F-type 77% (20/26) compared with G-type 39% (22/56); p<0.01) and more often associated with invasive disease (stage T2) (66% (10/15) v 33% (5/15); p<0.001). Fifty eight lesions underwent Endoscopic Mucosal Resection (G-type 64% (37/58)/F-type 36% (21/58)). Local recurrent disease was detected in 17% of patients (10/58), all within six months of the index Resection. Piecemeal Resection and G-type morphology were significantly associated with recurrent disease (p<0.1). Overall “cure” rates for lateral spreading tumours using Endoscopic Mucosal Resection at two years of follow-up was 96% (56/58). Conclusions: Endoscopic Mucosal Resection for lateral spreading tumours, staged as T1, is a safe and effective treatment despite their large size. Endoscopic Mucosal Resection may be an alternative to surgery in selected patients.

  • Colonoscopic Resection of lateral spreading tumours: a prospective analysis of Endoscopic Mucosal Resection
    Gut, 2004
    Co-Authors: David P Hurlstone, David S Sanders, Simon S Cross, I J Adam, Andrew J Shorthouse, S R Brown, K Drew, A J Lobo
    Abstract:

    Background: Lateral spreading tumours are superficial spreading neoplasms now increasingly diagnosed using chromoscopic colonoscopy. The clinicopathological features and safety of Endoscopic Mucosal Resection for lateral spreading tumours (G-type “aggregate” and F-type “flat”) has yet to be clarified in Western cohorts. Methods: Eighty two patients underwent magnification chromoscopic colonoscopy using the Olympus CF240Z by a single endoscopist. All patients had received a previous colonoscopy where an Endoscopic diagnosis of lateral spreading tumour was made. All lesions were examined initially using indigo carmine chromoscopy to delineate contour followed by crystal violet for magnification crypt pattern analysis. A 20 MHz “mini probe” ultrasound was used if T2 disease was suspected. Following Endoscopic Mucosal Resection, patients were followed up at 3, 6, 12, and 24 months using total colonoscopy. Results: Eighty two lateral spreading tumours were diagnosed in 80 patients (32% (26/82) F-type and 68% (56/82) G-type). G-type lesions were larger than F-type (G-type mean 42 (SD 14) mm v F-type 24 (6.4) mm; p