Successful resection of a 22-cm subcircumferential rectal lesion treated by endoscopic submucosal dissection with a mucosal-anchor-assisted multiple-tunnel method.

Abstract

Colorectal endoscopic submucosal dissection (ESD) has become widespread since the development of devices and traction or tunnel methods, but ESD for large lesions remains challenging. In particular, when ESD using the tunnel method is used on huge lesions, if the mucosa and submucosa remaining after tunnel creation are dissected, the dissected parts will accumulate on the oral side. This makes the final dissection difficult because the advantage of gravity is lost. We report a case of ESD of a large lesion using a modified tunnel method with a mucosal anchor.