Complication and local recurrence rate after endoscopic resection of large high-risk colorectal adenomas of ≥3 cm in size

Seidel, Judith; Farber, Eugene M.; Baumbach, R; Cordruwisch, W; Böhmler, U.; Feyerabend, Bernd; Faiss, Siegbert

doi:10.1007/s00384-015-2498-x

Cited by 17 publications

(9 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our cohort, lesion size was <5 mm in only two patients. Compliance with F/U may be a problem in these patients as recently shown by a retrospective study by Seidel and colleagues 22. This might result in larger residual/recurrent lesions which may impede retreatment.…”

Section: Discussionmentioning

confidence: 89%

Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications

Schmidt

Beyna

Schumacher

et al. 2017

Gut

245

310

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 89%

Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications

Schmidt

Beyna

Schumacher

et al. 2017

Gut

245

310

View full text Add to dashboard Cite

show abstract

“…We did not observe any deaths due to the interventions. Some studies have reported increased complication rates (bleeding and perforations) of endoscopic removal of larger lesions ≥30mm [ 12 , 23 , 26 , 35 ]. The perforation rate of our study in patients with polyps ≥40mm was similar to the perforation rate in patients with polyps of 20-40mm.…”

Section: Discussionmentioning

confidence: 99%

Safety of endoscopic mucosal resection (EMR) of large non-pedunculated colorectal adenomas in the elderly

Bronsgeest

Huisman

Langers

et al. 2017

Int J Colorectal Dis

View full text Add to dashboard Cite

BackgroundEndoscopic mucosal resection (EMR) has been proven to be safe and effective for the treatment of colorectal adenomas. However, data are limited on the safety of this technique for large polyps and in elderly patients. Aims of our study were to examine the bleeding and perforation rates in patients with large non-pedunculated adenomas (≥20mm) and to evaluate the influence of size (≥40mm) and age (≥75 years) on the complication rates.MethodsIn this multicenter retrospective study, patients who underwent EMR of non-pedunculated adenomas ≥20mm between January 2012 and March 2016 were included. The demographics of the patients, the use of antithrombotic drugs, size of the polyps, type of resection, pathology report, occurrence of post-polypectomy bleeding, and perforation- and recurrence rate were collected.ResultsIn 343 patients, 412 adenomas were removed. Eighty patients (23.3%) were ≥75 years of age, 138 polyps (33.5%) were ≥40mm. Bleeding complications were observed in 28 cases (6.8%) and were found significantly more frequent in adenomas ≥40mm, independent of the use of antithrombotic therapy. Five perforations (1.2%) were described, not related to the size of the polyp. There was no significant difference in complication rates between patients <75 years and patients ≥75 years. Bleeding complications rates were significantly higher in patients receiving double antithrombotic therapy.ConclusionEMR is safe in elderly patients. EMR of adenomas of ≥40mm was associated with more bleeding complications. Future studies should address how the bleeding rates can be reduced in these patients, especially in those who use double antithrombotic treatment.

show abstract

“…Recurrence after piecemeal EMR is a problem [2,5,12] and the risk of recurrence increases with the size of the lesion [2,3,5]. Also, incomplete adenoma resection has a significant impact on risk of interval cancer [13].…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up after colorectal endoscopic submucosal dissection in 182 cases

et al. 2021

View full text Add to dashboard Cite

Background and study aims We previously reported a case series of our first 182 colorectal endoscopic submucosal dissections (ESDs). In the initial series, 155 ESDs had been technically feasible, with 137 en bloc resections and 97 en bloc resections with free margins (R0). Here, we present long-term follow-up data, with particular emphasis on cases where either en bloc resection was not achieved or en bloc resection resulted in positive margins (R1). Patients and methods Between September 2012 and October 2015, we performed 182 consecutive ESD procedures in 178 patients (median size 41.0 ± 17.4 mm; localization rectum vs. proximal rectum 63 vs. 119). Data on follow-up were obtained from our endoscopy database and from referring physicians. Results Of the initial cohort, 11 patients underwent surgery; follow-up data were available for 141 of the remaining 171 cases (82,5 %) with a median follow-up of 2.43 years (range 0.15–6.53). Recurrent adenoma was observed in 8 patients (n = 2 after margin positive en bloc ESD; n = 6 after fragmented resection). Recurrence rates were lower after en bloc resection, irrespective of involved margins (1.8 vs. 18,2 %; P < 0.01). All recurrences were low-grade adenomas and could be managed endoscopically. Conclusions The rate of recurrence is low after en bloc ESD, in particular if a one-piece resection can be achieved. Recurrence after fragmented resection is comparable to published data on piecemeal mucosal resection.

show abstract

Complication and local recurrence rate after endoscopic resection of large high-risk colorectal adenomas of ≥3 cm in size

Cited by 17 publications

References 24 publications

Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications

Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications

Safety of endoscopic mucosal resection (EMR) of large non-pedunculated colorectal adenomas in the elderly

Long-term follow-up after colorectal endoscopic submucosal dissection in 182 cases

Contact Info

Product

Resources

About