|| Checking for direct PDF access through Ovid
In the last few years two methods have been established in the local excision of rectal adenomas or small carcinoma of the rectum: The endoscopic loop-mucosa-dissection piece-meal technique and the endoscopic-microsurgical excision. Both methods have disadvantages: In carrying out the endoscopic piece-meal technique only an uncontrolled submucosal dissection is possible, the evaluation of the infiltration of the carcinoma into the submucosa cannot be described exactly. The disadvantage of the endoscopic-microsurgical in total wall technique is especially perirectal cicatrisation or abscesses.Between 2002 and April 2010 we performed 178 endoscopic-microsurgical excisions (60% adenomas, 40% carcinomas). 22 out of them have been giant adenomas. These were resected by a new hydrojet-supported endoscopicmicrosurgical technique.The hydrojet-supported submucosal endoscopic-microsurgical excision allows the total excision of adenomas with a safe distance exactly at the level of the muscularispropria without complications and recurrence. We report about the new hydrojet technique in giant flat adenomas and follow-up data (median 5 months after excision).