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Rémi DUMAS

Centre Hospitalier Princesse Grace
Monaco, Monaco
MD
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LIVE INTERACTIVE SURGERY: Colonoscopy and resection of large pedunculated sigmoid colon polyp
An intestinal polyp is a mass of tissue, which arises from the bowel wall and protrudes into the lumen. Polyps may be sessile or pedunculated. The incidence of polyps ranges from 7 to 50%. Polyps are most commonly found in the rectum and sigmoid colon and decrease in frequency towards the caecum.
Symptoms and signs:
Polyps are usually asymptomatic. The most frequent complaint is rectal bleeding, which is usually occult. Abdominal pain and obstruction occur with large polyps. The main concern with polyps is the risk of malignant transformation.
Complications of polypectomy: Common complications following polypectomy are bleeding and infection. The risk of bleeding ranges from 0.2 to 1.2%. When patients are on blood thinners, the risk of bleeding increases to 6.8%.
Advantages and disadvantages of use of prophylactic clips:
Clips can be applied during the procedure itself. They are easy to deploy. No scarring can be observed.
Disadvantages:
They are expensive, and present a risk of perforation and further bleeding.
Surgical intervention
3 years ago
1098 views
39 likes
0 comments
11:52
LIVE INTERACTIVE SURGERY: Colonoscopy and resection of large pedunculated sigmoid colon polyp
An intestinal polyp is a mass of tissue, which arises from the bowel wall and protrudes into the lumen. Polyps may be sessile or pedunculated. The incidence of polyps ranges from 7 to 50%. Polyps are most commonly found in the rectum and sigmoid colon and decrease in frequency towards the caecum.
Symptoms and signs:
Polyps are usually asymptomatic. The most frequent complaint is rectal bleeding, which is usually occult. Abdominal pain and obstruction occur with large polyps. The main concern with polyps is the risk of malignant transformation.
Complications of polypectomy: Common complications following polypectomy are bleeding and infection. The risk of bleeding ranges from 0.2 to 1.2%. When patients are on blood thinners, the risk of bleeding increases to 6.8%.
Advantages and disadvantages of use of prophylactic clips:
Clips can be applied during the procedure itself. They are easy to deploy. No scarring can be observed.
Disadvantages:
They are expensive, and present a risk of perforation and further bleeding.
Video case: colon cancer
Endoscopic mucosal resection (EMR) is a method for treating early gastrointestinal mucosal lesions. The procedure of EMR involves submucosal injection of normal saline or saline with a mix of methylene blue to separate the lesion from the underlying muscle layers. The raised lesions can be completely removed with a snare. EMR is a simple and safe procedure with a small learning curve.
The risk of serious complications such as perforation and bleeding is rare.
The invasion depth of the tumor can be assessed after resection using pathological examination. The recurrence rate is very low (0-3.6%) after resection. EMR is not an appropriate choice for gastrointestinal tumors (size >20mm) as the complete recurrence rate is very low and recurrence after resection is very high.
Lecture
3 years ago
1071 views
41 likes
0 comments
11:03
Video case: colon cancer
Endoscopic mucosal resection (EMR) is a method for treating early gastrointestinal mucosal lesions. The procedure of EMR involves submucosal injection of normal saline or saline with a mix of methylene blue to separate the lesion from the underlying muscle layers. The raised lesions can be completely removed with a snare. EMR is a simple and safe procedure with a small learning curve.
The risk of serious complications such as perforation and bleeding is rare.
The invasion depth of the tumor can be assessed after resection using pathological examination. The recurrence rate is very low (0-3.6%) after resection. EMR is not an appropriate choice for gastrointestinal tumors (size >20mm) as the complete recurrence rate is very low and recurrence after resection is very high.