PMC5465755_01
Endoscopic images. a Local residual adenoma on the scar after incomplete endoscopic piecemeal mucosectomy in the rectum. b Laterally spreading tumor with no lifting sign, previously biopsied with histology positive for adenocarcinoma in situ. c, d Lesions marked with argon plasma coagulation.
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On endoscopy, at 5 cm above the dentate line, we observed a 20-mm local recurrent adenoma on the scar of a previous endoscopic mucosal resection of a laterally spreading tumor (pseudo-depressed type) with high-grade dysplasia and a 25-mm laterally spreading tumor (mixed type), with no lifting sign, previously biopsied with histology positive for adenocarcinoma in situ (Fig. 2).
Endoscopic images showing the target lesion that is grasped and pulled into the cap by the grasping forceps (a); the over-the-scope clip (OTSC) completely closing the full-thickness resection site (b); the rectal full-wall resection specimen (c); the serosal surface macroscopically visible on the specimen (d); two over-the-scope clips (OTSC) completely closing the full-thickness resection site (e); and the rectal full-wall resection specimen (f).
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Then, another FTRD was mounted on the tip of the colonoscope (CFQ-145I Olympus) and a second endoscopic full-thickness resection (EFTR) was performed (Fig. 3).