1513 Efficacy of the Traction Device “S-O Clip” Assisted ESD for the Colonic Tumor Involving a Diverticulum

Abstract

INTRODUCTION: Background: Endoscopic submucosal dissection (ESD) allows en bloc resection of large gastrointestinal neoplasms regardless of the size. However, technical difficulties associated with ESD in the colorectum make it less widely applied in the treatment of tumors in this region. To address this difficulty, we designed a traction device, called S-O clip and reported previously (Endoscopy2008, Gastrointest Endosc 2009). ESD with this device was effective for complete resection of large tumors (LSTs) (Surgical Endoscopy2014). Although the lesions of unusual sites such as within the appendix and diverticulum are very difficultto remove by ESD and sometime surgical treatment is required, We reported the first case of aLSTs involving a diverticulum successfully treated by ESD with this device (Gastrointest Endosc 2016). Aim: To evaluate the efficacy and safety of S-O clip assisted ESD for the tumor of the colon involving a diverticulum. CASE DESCRIPTION/METHODS: Results: 4 cases are LSTs involving a diverticulum in the ascending colon. One case is in the sigmoid colon. All 5 cases were removed safely and successfully en bloc without any complications. Procedure time s were 67, 145, 25, 68 and 64 minutes, with resected specimens measuring 20, 32, 20, 18 and 30 mm, respectively. DISCUSSION: Conclusion: This limited case series demonstrate that S-O clip-assisted ESD is safe and effective for en bloc resection of the colonic lesion involving a diverticulum.