ArticleVideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy2020
Double-tunneling butterfly method for endoscopic submucosal dissection of extensive rectal neoplasms.
Article in VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 16 citations in OpenAlex.
- An Y shaped tunnel to bypass a hemorrhoid band ligation scar during rectal endoscopic submucosal dissection.Endoscopy · 2025Article
- Endoscopic resection of colitis-associated neoplasia: A scoping review.World journal of gastrointestinal endoscopy · 2025Article
- Usefulness of the Bridge Formation Method for Colorectal Endoscopic Submucosal Dissection: A Propensity Score-Matched Study.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Clinical audit of endoscopic sub-mucosal dissection performed for complex lateral spreading colorectal tumors from a region non-endemic for colorectal cancer.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Article
- GI endoscopic submucosal dissection using a calibrated, small-caliber-tip, transparent hood for lesions with fibrosis.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2021Article
- Colorectal Endoscopic Submucosal Dissection: An Update on Best Practice.Clinical and experimental gastroenterology · 2021Review
- Endoscopic submucosal tunneling dissection: use of a novel bipolar radiofrequency and microwave-powered device for colorectal endoscopic submucosal dissection.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2020Article
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsEndoscopic submucosal dissection (ESD) is the preferred technique for en bloc resection of superficial colorectal neoplasms. Resection of extensive lesions with ESD can be challenging, owing to loss of orientation in the submucosal space. In this case series, we describe the double-tunneling (DoT) butterfly method for ESD of extensive rectal neoplasms.
methodsThe key feature of the DoT butterfly method is the creation of 2 tunnels that are transformed into bilateral flaps, leaving a submucosal septum between them.
resultsFour rectal neoplasms measuring (maximum diameter) 7 cm, 8 cm, 9 cm, and 18 cm, respectively, were resected in 4 patients by use of the DoT butterfly method. The lesions included recurrent adenoma (n = 1) and dysplasia (n = 1) in longstanding ulcerative colitis. Curative R0 resection was confirmed in all 4 cases. Histologic examination showed tubular adenomas with low-grade dysplasia in 1 of 4 patients and focal high-grade dysplasia in 3 of 4 patients. One patient experienced postprocedural bleeding that required endoscopic reintervention.
conclusionThe DoT butterfly method appears to be useful for the resection of extensive rectal neoplasms. A prospective study is required to assess whether these results can be reproduced in a large cohort of patients.
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