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“Purse-string” eschar closure after endoscopic submucosal dissection of a rectal lesion
“Purse-string” eschar closure after endoscopic submucosal dissection of a rectal lesion
Maria Manuela Estevinho, Rolando Pinho, Jaime Rodrigues, João Correia, Pedro Mesquita, Teresa Freitas
Centro Hospitalar Vila Nova de Gaia Espinho
A 60mm lateral spreading tumor, granular, nodular-mixed type, JNET 2A, was identified in the proximal rectum of a 48-year-old male. En bloc ESD was proposed. During the procedure, an area of absent elevation was seen, suggesting fibrosis or invasion. Dissection was completed around this area, isolating a pericentimetric zone. Then, the muscular layer was intentionally superficially sectioned to complete resection. The eschar was closed using endoscopic "purse string". The patient was discharged home asymptomatic after four hours of monitoring. Histological analysis revealed a moderately differentiated adenocarcinoma, invading the muscularis propria, with negative vertical and horizontal margins.
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