Knife-assisted resection of flat dysplastic lesions in colitis

摘要

The risk of colonic neoplasia is increased in inflammatory bowel disease. Flat dysplastic lesions in colitis can bedifficult to detect and challenging to resect endoscopically.Conventional EMR has been used, but because theselesions are often flat morphologically, the snare slips off.Endoscopic submucosal dissection (ESD) has been shownto be able to resect flat lesions; however, they carry a highperforation rate outside the rectum. Knife-assisted snareresection (KAR) is a novel technique that combines theprinciples of EMR and ESD. We evaluate the safety andefficacy of this technique in resecting flat dysplastic lesionsin colitis, and we demonstrate the technique in Video 1.