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214
OBSTACLES DURING ENDOSCOPIC RESECTION OF A GIANT FIBROVASCULAR POLYP (GFVP) ORIGINATING FROM PROXIMAL ESOPHAGUS
Date
May 18, 2024
Treatment for GFVP often involves aggressive surgical measures. ESD of esophageal GFVP presents various challenges, such as determining the polyp base and managing a highly vascular stump. Extracting the polyp and dealing with the residual stump after resection can lead to a choking or throat lump sensation. Thus, our strategy highlights a high incision close to its base with cautious submucosal dissection with prophylactic and active vascular Coagulation. We extracted the giant polyp in piecemeal fashion after en-block resection for pathological examination. Despite of the high incision, we applied a band ligation to divert the residual lump away from the airway.
Different ESD strategies are applied to facilitate the resection of large lesions like the tunneling technique and pocket creation method. One of the challenges during tunneling in large lesions is the narrow working space, looping with the risk of muscle or mucosal injury…