Читать книгу Gastrointestinal Pathology - Группа авторов - Страница 18

Increasingly, endoscopic resection is being used for definitive oncologic removal of precancerous and invasive lesions. In these cases it is advantageous to orient the specimen so that precise staging as well as margin assessment can be performed. A typical situation is in endoscopic resection of early neoplasia in the esophagus such as Barrett's esophagus. In this case a sample is frequently obtained through endoscopic mucosal resection. Large pieces of tissue, typically 1–2 cm in diameter, can be obtained to a depth of the submucosa. In this case the sample should be removed from the patient in a way that does not damage or distort the tissue. This is typically performed by suctioning the tissue into a distal attachment cap/hood and then removing the endoscope. Alternative retrieval devices include a modified snare with a protective net. These tissues should then be immediately oriented at the bedside typically by placing them on a paraffin or similar firm block. The tissue should be flattened typically with the mucosal side up and the edges carefully pinned so that the tissue remains flat (Figure 1.10).