Endoscopic submucosal dissection of a large cecal tumor extending into the appendiceal orifice in a patient with intact appendix

摘要

Endoscopic resection of cecal tumors extending into the appendiceal orifice in patients with intact appendix is known to be technically difficult, associated with higher risk of perforation and appendicitis. Consequently, surgical resection has been the conventional treatment even for ad- enomas. 1,2 Recently, there have been some reports of endoscopic resection for similar tumors as a result of improved devices and accumulated experience with these complex resections. However, reported experience on the safety and effectiveness of endoscopic resection is lacking, and the best management for these lesions is still variable depending on the availability of expertise. Here we present a case of a large laterally spreading tumor-granular type (LST-G) extending into the appendi- ceal orifice with an intact appendix, resected successfully by en bloc endoscopic submucosal dissection (ESD).