Endoscopic submucosal dissection of early-stage rectal cancer using full-time red dichromatic imaging to minimize and avoid significant bleeding

摘要

Management of bleeding during endoscopic resections (and even more so in endoscopic submucosal dissection [ESD]) is a critical aspect of the procedure. The low rectum has a higher risk of bleeding because of a rich venous plexus; this can increase procedure time compared with the proximal rectum. 1 Red dichromatic imaging (RDI), a novel image- enhanced endoscopy technology, has been reported to improve the visibility of deep vessels and bleeding points compared with white-light imaging (WLI). 2-4 WLI can be switched to RDI instantly with the press of a single button on the endoscope. We present a case of ESD in the low rectum in which RDI was very useful and effective.