{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T08:55:09Z","timestamp":1769849709174,"version":"3.49.0"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"12","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background and study aims For pedunculated colon polyps, en bloc resection with inclusion of the polyp stalk is necessary to yield an accurate histologic staging. This can be challenging in cases of a large polyp and\/or broad stalk using conventional snare resection. We evaluated the feasibility of endoscopic submucosal dissection (ESD) for large pedunculated polyps with broad stalks.<\/jats:p><jats:p>\n            Patients and methods Between February 2019 and November 2021 all patients with large pedunculated polyps defined as polyp diameter \u2265 20 mm and or a broad stalk &gt; 5 mm were enrolled in the study. All polyps were resected in ESD technique with dissection of the polyp stalk at the base after injection.<\/jats:p><jats:p>\n            Results Twenty-five patients (male = 18, age mean: 67 years) were\n      included. En bloc resection was achieved in 100% of the patients (25\/25 polyps). Polyps were\n      mainly located in the sigmoid (n = 19) and rectum (n = 3). Median polyp size was 30\u00d725\u00d717 mm.\n      Histologic examination revealed the following results: adenoma low-grade intraepithelial\n      neoplasia (LG-IEN): nine; high-grade intraepithelial neoplasia (HG-IEN): seven; pTis: three;\n      adenoarcinoma: five (G1, pT1, L0, V0, Haggitt 3: 2\/G2, pT1, L0, V0, Haggitt 3:2\/G3, pT1, Bd3,\n      V1, Haggitt 4: 1); other: 1.<\/jats:p><jats:p>R0 resection rate was 100% and the curative resection rate yielded 96% (24\/25) without severe adverse events.<\/jats:p><jats:p>\n            Conclusions ESD achieved high en bloc and R0 resection rates for large pedunculated polyps. In our collective, up to 32% of polyps already had adenocarcinoma, resulting in a high curative resection rate due to complete resection and subsequently accurate risk classification.<\/jats:p>","DOI":"10.1055\/a-2427-1948","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T22:59:03Z","timestamp":1727737143000},"page":"E1437-E1446","source":"Crossref","is-referenced-by-count":2,"title":["Endoscopic submucosal dissection of colorectal pedunculated polyps"],"prefix":"10.1055","volume":"12","author":[{"given":"Johanna Katharina","family":"Jakobs","sequence":"additional","affiliation":[{"name":"Gastroenterology, University Hospital of Giessen and Marburg Campus Marburg, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malte","family":"Zumblick","sequence":"additional","affiliation":[{"name":"Gastroenterology, University Hospital of Giessen and Marburg Campus Marburg, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"von Gerlach","sequence":"additional","affiliation":[{"name":"Pathology, University Hospital of Giessen and Marburg Campus Marburg, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petros","family":"Stathopoulos","sequence":"additional","affiliation":[{"name":"Gastroenterology, University Hospital of Giessen and Marburg Campus Marburg, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Glas","sequence":"additional","affiliation":[{"name":"Gastroenterology, University Hospital of Giessen and Marburg Campus Marburg, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten","family":"Denkert","sequence":"additional","affiliation":[{"name":"Pathology, University Hospital of Giessen and Marburg Campus Marburg, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike Walburga","family":"Denzer","sequence":"additional","affiliation":[{"name":"Division of Interdisciplinary Endoscopy, University Hospital of Giessen and Marburg Campus Marburg Clinic for Gastroenterology Endocrinology Metabolism and clinical Infectiology, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,12,6]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1016\/j.gie.2014.12.010","article-title":"Endoscopic submucosal dissection","volume":"81","author":"Committee ASGE Technical","year":"2015","journal-title":"Gastrointest Endosc"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"F Bray","year":"2018","journal-title":"CA Cancer J Clin"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/0092-8674(90)90186-I","article-title":"A genetic model for colorectal tumorigenesis","volume":"61","author":"ER Fearon","year":"1990","journal-title":"Cell"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1056\/NEJM199312303292701","article-title":"Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup","volume":"329","author":"SJ Winawer","year":"1993","journal-title":"N Engl J Med"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1055\/s-0043-121106","article-title":"S3-Leitlinie \u2013 Kolorektales Karzinom","volume":"55","author":"W Schmiegel","year":"2017","journal-title":"Z Gastroenterol"},{"key":"ref6","first-page":"E1","article-title":"S2k guideline: quality requirements for gastrointestinal endoscopy, AWMF registry no. 021\u2013022","volume":"53","author":"U Denzer","year":"2015","journal-title":"Z Gastroenterol"},{"key":"ref7","first-page":"673","article-title":"Endoscopic mucosal resection is effective for laterally spreading lesions at the anorectal junction","volume":"69","author":"N Shahidi","year":"2019","journal-title":"Endoscopy"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1053\/j.gastro.2022.07.002","article-title":"Long-term outcomes after endoscopic submucosal dissection for large colorectal epithelial neoplasms: a prospective, multicenter, cohort trial from Japan","volume":"163","author":"K Ohata","year":"2022","journal-title":"Gastroenterology"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.gie.2022.02.017","article-title":"Endoscopic submucosal dissection for removal of large colorectal neoplasias in an outpatient setting: a single-center series of 660 procedures in Sweden","volume":"96","author":"V Tidehag","year":"2022","journal-title":"Gastrointest Endosc"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00053-016-0090-7","article-title":"Management und Therapie des kolorektalen Fr\u00fchkarzinoms","author":"C Margreiter","year":"2016","journal-title":"Coloproctology"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1097\/DCR.0b013e318276d2b9","article-title":"Can endoscopic submucosal dissection technique be an alternative treatment option for a difficult giant (>\/= 30 mm) pedunculated colorectal polyp?","volume":"56","author":"YS Choi","year":"2013","journal-title":"Dis Colon Rectum"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"E924","DOI":"10.1055\/a-2113-9626","article-title":"Targeted coagulation of large stalk vessels in giant pedunculated colorectal polyp: is endoscopic submucosal dissection the new way to go?","volume":"55","author":"L Queneherve","year":"2023","journal-title":"Endoscopy"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1055\/a-1194-4413","article-title":"Endoscopic submucosal dissection of large pedunculated polyps with wide stalks: a retrospective multicenter study","volume":"53","author":"H Chiba","year":"2021","journal-title":"Endoscopy"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"e277","DOI":"10.1002\/deo2.277","article-title":"Clinical outcomes of endoscopic submucosal dissection for large pedunculated colorectal carcinoma: A retrospective multicenter study","volume":"4","author":"K Inagaki","year":"2024","journal-title":"DEN Open"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.vgie.2020.02.016","article-title":"Endoscopic resection of large pedunculated colon polyps using only a scissor-type knife: a case series","volume":"5","author":"S Jawaid","year":"2020","journal-title":"VideoGIE"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1055\/a-1811-7025","article-title":"Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - 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