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Also by piecemeal removal of data points?
Colorectal ESD is indicated for lesions that can be managed endoscopically and which require en bloc excision, but would require piecemeal removal if treated with snare EMR.
It has since been shown that pseudo-capsule resection produces a faster postoperative decline in cortisol than piecemeal removal, but it does not have as rapid a decline as seen after hypophysectomy [ 30].
61 Unlike en bloc retrieval, piecemeal removal results in the retrieval of poorer quality histological samples and it is often not possible to evaluate the completeness of resection, depth of invasion, lateral resection margins and other prognostic features.
59 60 Piecemeal removal of malignancy has also been identified as an independent risk factor for incomplete resection by a 2011 Korean study (n=236, OR=3.365, 95% CI 1.295 to 8.744, p=0.013).
A 2014 meta-analysis of 33 studies examining snare removal of NPCPs unequivocally demonstrates lower recurrence with en bloc resection than with piecemeal removal (3%9595% CI 2%to5%5%) vs 20%9595% CI 16%to25%5%), p<0.0001).
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Sessile adenomas that were removed piecemeal required 2 6 months follow-up to verify complete removal.
55 Unlike piecemeal resection, en bloc removal may be effective as both a diagnostic and therapeutic tool where a suspicion of malignancy exists.
According to the Guidelines for Colonoscopy Surveillance after EMR: a consensus update by the US Multi-Society Task FonColorectalreCancerander and the American Cancer Society, patients with sessile adenomas that are removed piecemeal should be considered for follow up evaluation at shorter intervals (2-6 montos) to verify complete removal.
The entire sacrum, along with the tumor, was removed piecemeal.
In Johannesburg, the Natives Resettlement Act, Act No 19 (1954) and central government pressure resulted in an acceleration of the city council's earlier piecemeal 'slum clearances', facilitating the removal of Africans from Johannesburg's western areas, such as Sophiatown, to new gridded suburbs south-west of the city, such as Soweto, shown on the map.
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