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OBSTACLES DURING ENDOSCOPIC RESECTION OF A GIANT FIBROVASCULAR POLYP (GFVP) ORIGINATING FROM PROXIMAL ESOPHAGUS
Ahmad a. Madkour
1, Amr Abdelazem
1, Osama Elnahas
1, Dalia Abd El-Kareem
2, Adham Haggag
3, Kirollus Abdallah
1, Amr El Fouly
*11Hepatology and Gastroenterology, Helwan University, Helwan, Cairo, Egypt; 2Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt; 3Ain Shams University Faculty of Medicine, Cairo, Egypt
Treatment for GFVP often involves aggressive surgical measures. ESD of esophageal GFVP presents various challenges, such as determining the polyp base and managing a highly vascular stump. Extracting the polyp and dealing with the residual stump after resection can lead to a choking or throat lump sensation. Thus, our strategy highlights a high incision close to its base with cautious submucosal dissection with prophylactic and active vascular Coagulation. We extracted the giant polyp in piecemeal fashion after en-block resection for pathological examination. Despite of the high incision, we applied a band ligation to divert the residual lump away from the airway.
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