How do you approach circumferential suspicious Polypoidal mid Rectal lesion which yield high grade dysplasia by 2 different senior endoscopist?
According to the Paris classification, lesions greater than 2.5 mm in height are considered polypoid. Two attempts of biopsies have already proved HGD. Therefore, polypectomy would be the next step. Biopsies should be used with caution, since they can cause fibrosis in the biopsied area and thus, prevents endoscopic resection. Chromoendoscopy, EUS or MRI should be considered for the estimation of submucosal invasion of the lesion. EMR/ESD could be the option depends on the depth of invasion.
An MRI need to be done to exclude mural invasion. TEMS/TEO/TAMIS May all be used but need a quite experienced surgeon for the circumferential nature of the lesion. Any doubt, a formal resection (Ant Res) is indicated
- Badges
- Science topic
- Similar topics
- Phytochemistry
- Extracts