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Role of intraoperative patients positioning in endoscopic full-thickness resection of large gastric tumors under general anesthesia

Full thickness endoscopic resection of large submucosal gastric tumors (>3 cm) is a big challenge for endoscopists. Issues include how to efficiently resect the lesion, obtain homeostasis, and suture the defect. There are no guidelines regarding the importance of patient position on the success o...

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Autores principales: Zhou, Li-Jun, Xing, Fei, Chen, Dan, Li, Yan-Na, Rafiq, Shoaib Mohammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9389534/
https://www.ncbi.nlm.nih.gov/pubmed/35992803
http://dx.doi.org/10.3389/fonc.2022.985257
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author Zhou, Li-Jun
Xing, Fei
Chen, Dan
Li, Yan-Na
Rafiq, Shoaib Mohammad
author_facet Zhou, Li-Jun
Xing, Fei
Chen, Dan
Li, Yan-Na
Rafiq, Shoaib Mohammad
author_sort Zhou, Li-Jun
collection PubMed
description Full thickness endoscopic resection of large submucosal gastric tumors (>3 cm) is a big challenge for endoscopists. Issues include how to efficiently resect the lesion, obtain homeostasis, and suture the defect. There are no guidelines regarding the importance of patient position on the success of endoscopic resections in anesthetized patients. Typically, the patient is placed in left lateral position for the endoscopic therapy and during the procedure patient’s position is changed to maintain the tumor above the gastric fluids to prevent gastric juices and tumor or tumor fragments from falling into the peritoneal cavity in the event of perforation. This study emphasized the importance of planning the procedure to ensure that the patient’s position and anesthetist’s concerns are met and allow optimal access to the lesion for endoscopic resection. Prior to sedation the patient should be positioned so that the tumor is in the up position which also prevents blood obscuring the operative field, helps detect bleeding points for immediately hemostasis. In addition, due to gravitational effect, the resected tumor will fall into the gastric cavity exposing the root of the tumor making resection easier and reduce procedure time. Preplanning avoids unnecessary readjustment of positioning and improves the ease and safety of the procedure.
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spelling pubmed-93895342022-08-20 Role of intraoperative patients positioning in endoscopic full-thickness resection of large gastric tumors under general anesthesia Zhou, Li-Jun Xing, Fei Chen, Dan Li, Yan-Na Rafiq, Shoaib Mohammad Front Oncol Oncology Full thickness endoscopic resection of large submucosal gastric tumors (>3 cm) is a big challenge for endoscopists. Issues include how to efficiently resect the lesion, obtain homeostasis, and suture the defect. There are no guidelines regarding the importance of patient position on the success of endoscopic resections in anesthetized patients. Typically, the patient is placed in left lateral position for the endoscopic therapy and during the procedure patient’s position is changed to maintain the tumor above the gastric fluids to prevent gastric juices and tumor or tumor fragments from falling into the peritoneal cavity in the event of perforation. This study emphasized the importance of planning the procedure to ensure that the patient’s position and anesthetist’s concerns are met and allow optimal access to the lesion for endoscopic resection. Prior to sedation the patient should be positioned so that the tumor is in the up position which also prevents blood obscuring the operative field, helps detect bleeding points for immediately hemostasis. In addition, due to gravitational effect, the resected tumor will fall into the gastric cavity exposing the root of the tumor making resection easier and reduce procedure time. Preplanning avoids unnecessary readjustment of positioning and improves the ease and safety of the procedure. Frontiers Media S.A. 2022-08-05 /pmc/articles/PMC9389534/ /pubmed/35992803 http://dx.doi.org/10.3389/fonc.2022.985257 Text en Copyright © 2022 Zhou, Xing, Chen, Li and Rafiq https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Zhou, Li-Jun
Xing, Fei
Chen, Dan
Li, Yan-Na
Rafiq, Shoaib Mohammad
Role of intraoperative patients positioning in endoscopic full-thickness resection of large gastric tumors under general anesthesia
title Role of intraoperative patients positioning in endoscopic full-thickness resection of large gastric tumors under general anesthesia
title_full Role of intraoperative patients positioning in endoscopic full-thickness resection of large gastric tumors under general anesthesia
title_fullStr Role of intraoperative patients positioning in endoscopic full-thickness resection of large gastric tumors under general anesthesia
title_full_unstemmed Role of intraoperative patients positioning in endoscopic full-thickness resection of large gastric tumors under general anesthesia
title_short Role of intraoperative patients positioning in endoscopic full-thickness resection of large gastric tumors under general anesthesia
title_sort role of intraoperative patients positioning in endoscopic full-thickness resection of large gastric tumors under general anesthesia
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9389534/
https://www.ncbi.nlm.nih.gov/pubmed/35992803
http://dx.doi.org/10.3389/fonc.2022.985257
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