Effect of time of day and daily endoscopic workload on outcomes of endoscopic mucosal resection for large sessile colon polyps

Abstract

Background: Endoscopic mucosal resection of large non-pedunculated colon polyps is challenging. Objective: To determine if the time of day or daily endoscopic workload play a role in outcomes of endoscopic mucosal resection for large non-pedunculated colon polyps greater than 20 mm. Methods: This is a retrospective study of patients who underwent endoscopic mucosal resection of large non-pedunculated colon polyps. The time of day and endoscopic workload were compared across the following outcomes: the rate of complete resection of the polyp, the rate of referral for surgery, and the rate of residual neoplasia on follow-up. Results: One hundred and three endoscopic mucosal resection procedures were performed. There were no differences in the rates of complete resection (80.8% vs. 70.0%; P ¼ 0.25), the need for surgery (27.4% vs. 33.3%; P ¼ 0.55), and rate of residual neoplasia (24.5% vs. 50.0%; P ¼ 0.07) when comparing the time of day. Colon polyps greater than 40 mm were less likely to be completely resected versus polyps sized 20-39 mm (56.8% vs. 91.9%; P < 0.001). In cases with no residual neoplasia on follow-up, the mean duration for the index procedure was 45.6 minutes versus 60.7 minutes when there was residual neoplasia (P < 0.01). Conclusion: The time of day and endoscopic workload does not affect outcomes for endoscopic mucosal resection of large non-pedunculated colon polyps, but the size of large non-pedunculated colon polyps and resection times do.

Analysis of Tissue Eosinophils in the Structure of Gastri C Polyps

“…According to Chetty R. ( 2016), at the present stage, the most discussed are the mechanisms of dysplasia, as well as issues related to the nomenclature, diagnostic criteria, histological variants, coexistence with other types of polyps, and those differential diagnosis [3]. The exceptional immunological properties of eosinophils and their ability to induce tissue remodeling, which is especially important in the destruction and disruption of cellular interactions in the system of epithelial-mesenchymal tissues during carcinogenesis, puts the study of eosinophilic infiltration during tissue malignancy at the forefront of relevance [4,5]. Cansiz Ersöz C., Kiremitci S., Savas B., Ensari A .. (2020) recognize eosinophilia against the background of polyps in 88% with high sensitivity and specificity in predicting carcinogenesis [6].…”

Effectiveness of underwater endoscopic mucosal resection versus conventional endoscopic mucosal resection for 10 to 20 mm colorectal polyps

“…[ 4 ] EMR involves fluid injection into the submucosa for creation of a cushion that separates superficial lesions from the underlying muscularis propria to decrease the risk of full-thickness colonic perforation, facilitate entrapment within a snare and militate against transmural thermal injury. [ 5 – 7 ] While conventional EMR has some limitations. [ 8 – 12 ] Submucosal injection may displace the polyp into a less accessible location and constrict the lumen, making it more difficult to access the lesion.…”