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dc.contributor.authorWillingham, Field F.
dc.contributor.authorGee, Denise W.
dc.contributor.authorSylla, Patricia
dc.contributor.authorLauwers, Gregory Y.
dc.contributor.authorRattner, David William
dc.contributor.authorBrugge, William Robert
dc.date.accessioned2018-03-27T18:04:41Z
dc.date.issued2009
dc.identifier.citationWillingham, Field F., Denise W. Gee, Patricia Sylla, Gregory Y. Lauwers, David W. Rattner, and William R. Brugge. 2009. “En Bloc Esophageal Mucosectomy for Concentric Circumferential Mucosal Resection (with Video).” Gastrointestinal Endoscopy 69 (1) (January): 147–151. doi:10.1016/j.gie.2008.09.010.en_US
dc.identifier.issn0016-5107en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:35140968
dc.description.abstractBackground: With conventional EMR, specimens are fragmented, metaplasia may be left behind, and invasive lesions could be missed because of incomplete sampling. Concentric subtotal esophageal mucosectomy would address these limitations. Objective: To examine en bloc esophageal mucosectomy (EEM). Design: A prospective case series. Setting: An academic hospital. Subjects: Nine swine. Interventions: Conventional EMR was performed in the proximal esophagus. The submucosal space was entered, and the distal two thirds of the esophageal mucosa was freed with blunt dissection. A snare was threaded over the column of mucosa to the gastroesophageal junction. The column was resected, and the mucosa was retrieved. Main Outcome and Measurements: Clinical examination, follow-up endoscopy, necropsy, and gross and histopathologic examination. Results: EEM permitted subtotal esophageal mucosectomy in 9 of 9 swine (tissue specimens removed ranged 9-15 cm in length). The mean procedure duration was 110 minutes. In the survival series, 4 of 4 swine thrived after surgery, for 9 to 13 days. At 9 days, there was no evidence of a perforation, stricture, or leak. At 13 days, 2 swine had a mild proximal stricture, which was easily traversed with a 9.8-mm gastroscope. On necropsy, the mediastinal and thoracic cavities were unremarkable in 3 of 4 swine. One swine was found to have a contained abscess containing cellulose, presumably secondary to ingestion of wood-chip bedding material postoperatively. Reepithelialization was present on histologic examination. Limitations: An animal study. Conclusions: EEM is feasible and enabled concentric subtotal esophageal mucosal resection. The technique could completely and circumferentially excise intramucosal lesions. Longer follow-up and larger studies are needed to evaluate infection, stricture, and safety.en_US
dc.language.isoen_USen_US
dc.publisherElsevier BVen_US
dc.relation.isversionofdoi:10.1016/j.gie.2008.09.010en_US
dash.licenseMETA_ONLY
dc.titleEn bloc esophageal mucosectomy for concentric circumferential mucosal resection (with video)en_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalGastrointestinal Endoscopyen_US
dash.depositing.authorLauwers, Gregory Y.
dash.embargo.until10000-01-01
dc.identifier.doi10.1016/j.gie.2008.09.010*
workflow.legacycommentsnoap.needmanen_US
dash.contributor.affiliatedGee, Denise
dash.contributor.affiliatedSylla, Patricia
dash.contributor.affiliatedRattner, David
dash.contributor.affiliatedBrugge, William
dash.contributor.affiliatedLauwers, Gregory Y.


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