Endoscopic mucosal resection (EMR) in the management of large colo‐rectal polyps

Jameel, Jainudeen K.A.; Pillinger, Stephen H.; Moncur, Peter; Tsai, Her Hsin; Duthie, G. S.

doi:10.1111/j.1463-1318.2006.00966.x

Cited by 42 publications

(31 citation statements)

References 17 publications

(18 reference statements)

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“…EMR is a technique that can be applied to sessile and flat lesions. Though initially used for the treatment of early gastric cancer in Japan, the technique has been expanded to the therapy of large colorectal neoplasms [7] . This meta-analysis revealed that en-bloc resection was achieved in 62.85% of lesions and tumor-free vertical and lateral margins were achieved in 58.6%.…”

Section: Discussionmentioning

confidence: 99%

“…When these techniques are not used or possible, patients are frequently referred for surgical resection [6] . EMR has been shown to be useful in the removal of large colorectal sessile and flat lesions [7] . However, there are limits to the size of lesions which can be removed en-bloc with the various EMR techniques, with 1.5-2 cm generally being the upper limit [8] .…”

Section: Introductionmentioning

confidence: 99%

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Meta-analysis and systematic review of colorectal endoscopic mucosal resection

Puli¹,

Kakugawa²,

Gotoda³

et al. 2009

WJG

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AIM:To evaluate the proportion of successful complete cure en-bloc resections of large colorectal polyps achieved by endoscopic mucosal resection (EMR). METHODS:Studies using the EMR technique to resect large colorectal polyps were selected. Successful complete cure en-bloc resection was defined as one piece margin-free polyp resection. Articles were searched for in Medline, Pubmed, and the Cochrane Control Trial Registry, among other sources. RESULTS:An initial search identified 2620 reference articles, from which 429 relevant articles were selected and reviewed. Data was extracted from 25 studies (n = 5221) which met the inclusion criteria. All the studies used snares to perform EMR. Pooled proportion of en-bloc resections using a random effect model was 62.85% (95% CI: 51.50-73.52). The pooled proportion for complete cure en-bloc resections using a random effect model was 58.66% (95% CI: 47.14-69.71). With higher patient load (> 200 patients), this complete cure en-bloc resection rate improves from 44.19% (95% CI:24.31-65.09) to 69.17% (95% CI: 51.11-84.61). CONCLUSION:EMR is an effective technique for the resection of large colorectal polyps and offers an alternative to surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Meta-analysis and systematic review of colorectal endoscopic mucosal resection

Puli¹,

Kakugawa²,

Gotoda³

et al. 2009

WJG

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“…Adenoma é precursor do câncer colorretal 1-2 e a sua remoção serve como prevenção 3,4,5,6 . A intenção deste estudo é de avaliar os efeitos adversos da polipectomia realizada com alça diatérmica.…”

Section: Introductionunclassified

“…

Tratalho realizado no Serviço de Coloproctologia do HSE-RJ e no Serviço de Endoscopia Digestiva da Casa de Portugal -RJ.

Recebido em 19/03/2009 Aceito para publicação em 28/04/2009

INTRODUÇÃOAdenoma é precursor do câncer colorretal 1-2 e a sua remoção serve como prevenção 3,4,5,6 . A intenção deste estudo é de avaliar os efeitos adversos da polipectomia realizada com alça diatérmica.

PACIENTES E MÉTODOS

Analisamos de forma retrospectiva 1687 polipectomias com alça diatérmica realizadas em 8447 colonoscopias em duas instituições médicas no período de 2001 a 2007.

…”

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Colonoscopia com polipectomia: análise crítica de fatores de risco e complicações

Silva

Pelosi²,

Freitas³

et al. 2009

Rev bras. colo-proctol.

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Tratalho realizado no Serviço de Coloproctologia do HSE-RJ e no Serviço de Endoscopia Digestiva da Casa de Portugal -RJ. Recebido em 19/03/2009 Aceito para publicação em 28/04/2009 INTRODUÇÃOAdenoma é precursor do câncer colorretal 1-2 e a sua remoção serve como prevenção 3,4,5,6 . A intenção deste estudo é de avaliar os efeitos adversos da polipectomia realizada com alça diatérmica. PACIENTES E MÉTODOSAnalisamos de forma retrospectiva 1687 polipectomias com alça diatérmica realizadas em 8447 colonoscopias em duas instituições médicas no período de 2001 a 2007. Duzentos e três pólipos eram maiores do que 2 cm de diâmetro. Teste t de Student foi utilizado para análise de média e desvio padrão e qui-quadrado para números absolutos. P < que 0,05 foi considerado significante. As grandes lesões sésseis foram abordadas por técnica combinada, isto é, polipectomia convencional com alça diatérmica complementada por mucosectomia para retirada completa e segura das margens. Não abordamos neste estudo ressecções de lesões planas ou plana-elevadas por mucosectomia. RESULTADOSEm 1687 polipectomias, 203 foram para pólipos maiores do que 2 cm, considerados grandes, sendo que o maior deles tinha10 cm de diâmetro.A tabela 1 mostra a incidência de sangramento imediato quando comparamos o tamanho dos pólipos.Sangramento tardio, aquele que ocorreu após 24 h do procedimento pode ser visto na tabela 2.

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“…EMR is most commonly used to locally treat early gastric and esophageal dysplasia/cancer. However, there are several reports describing EMR as a therapeutic option for ampullary masses, colorectal cancer, and large colorectal polyps [7][8][9][10] . In the Western world, the predominant indication for EMR in the upper GI tract is the staging and treatment of early neoplasia in Barrett's esophagus.…”

Section: Endoscopic Mucosal Resection (Emr) Is a Technique Usedmentioning

confidence: 99%

Endoscopic mucosal resection in the upper gastrointestinal tract

Ahmadi¹,

Draganov²

2008

WJG

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Endoscopic mucosal resection (EMR) is a technique used to locally excise lesions confined to the mucosa. Its main role is the treatment of advanced dysplasia and early gastrointestinal cancers. EMR was originally described as a therapy for early gastric cancer. Recently its use has expanded as a therapeutic option for ampullary masses, colorectal cancer, and large colorectal polyps. In the Western world, the predominant indication for EMR in the upper gastrointestinal tract is the staging and treatment of advance dysplasia and early neoplasia in Barrett's esophagus. This review will describe the basis, indications, techniques, and complications of EMR, and its role in the management of Barrett's esophagus.

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Endoscopic mucosal resection (EMR) in the management of large colo‐rectal polyps

Cited by 42 publications

References 17 publications

Meta-analysis and systematic review of colorectal endoscopic mucosal resection

Meta-analysis and systematic review of colorectal endoscopic mucosal resection

Colonoscopia com polipectomia: análise crítica de fatores de risco e complicações

Endoscopic mucosal resection in the upper gastrointestinal tract

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