Endoscopic Mucosal Resection for Colonic Non-polypoid Neoplasms

Su, Ming Yao; Hsu, Chen Ming; Ho, Yu Pin; Lien, Jau Min; Lin, Chun-Jung; Chiu, Chien-Hung; Chen, Pang Chi; Tung, Shui‐Yi; Wu, Chia‐Chen

doi:10.1111/j.1572-0241.2005.00267.x

Cited by 48 publications

(53 citation statements)

References 26 publications

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“…The rate of bleeding observed is similar to that reported in the literature [6,17,18,19,20,21,22,23,24,25,26,27,28,29,30]. …”

Section: Discussionsupporting

confidence: 79%

“…The presence of normal colorectal mucosa around the excised tumor and the absence of tumor cells in the mucosectomy base are required to consider the endoscopic resection histologically complete; however, sometimes en bloc resection of these lesions is not possible, especially if larger than 3 cm, and piecemeal resection is required [25,37]. …”

Section: Discussionmentioning

confidence: 99%

“…The high frequency of local recurrence (up to 46%) after endoscopic resection for large colorectal tumors is a serious problem and an endoscopic follow-up is essential [6,7,17,18,19,20,21,22,23,24,25,26,27,28,29,30,34,35]. …”

Section: Discussionmentioning

confidence: 99%

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Efficacy, Safety and Outcomes of ‘Inject and Cut’ Endoscopic Mucosal Resection for Large Sessile and Flat Colorectal Polyps

Ferrara

Luigiano²,

Ghersi³

et al. 2010

Digestion

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Background and Study Aims: The study examines the outcomes of the ‘inject and cut’ endoscopic mucosal resection (EMR), for large sessile and flat colorectal polyps. Patients and Methods: Between January 2006 and December 2008 all patients referred to our institution for EMR of large polyps were prospectively evaluated. The accuracy of lifting sign and the rate of en bloc and piecemeal resection, complications and recurrence were analyzed. Results: A total of 157 patients with 182 lesions (median size 24.7 ± 10.2 mm) were included in the study. The most frequent location was the sigmoid colon in 30.2%. Because of non-lifting sign, 5/182 lesions were referred to surgical resection and 177 (43 flat and 134 sessile) were resected, 79 (44.6%) en bloc and 98 (55.4%) piecemeal. There were 20 procedural (11.3%) and 2 late (1.1%) bleeding, 4 post-polypectomy syndrome (2.2%) and 2 perforations (1.1%). Bleeding was related to malignancy (p = 0.01). Intramucosal cancer was observed in 5 cases (2.8%) while invasive cancer was seen in 8 (4.5%). Malignancy was related to polyp size ≧30 mm (p = 0.002). Follow-up colonoscopy was performed in 147 patients with 172 EMR for a mean of 19.8 months. Recurrence was observed in 12/172 (6.9%) polyps. Conclusion: Inject and cut EMR is practical and effective with a low risk of complication and local recurrence.

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“…The rate of bleeding observed is similar to that reported in the literature [6,17,18,19,20,21,22,23,24,25,26,27,28,29,30]. …”

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy, Safety and Outcomes of ‘Inject and Cut’ Endoscopic Mucosal Resection for Large Sessile and Flat Colorectal Polyps

Ferrara

Luigiano²,

Ghersi³

et al. 2010

Digestion

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“…Regarding recurrence, data in the literature range from 1.2% to 55% (14,19,31,44,54) . Most series have reported a higher recurrence rate associated with piecemeal resection as compared to en bloc resection (11,31,33) .…”

Section: Discussionmentioning

confidence: 99%

“…EMR is a less invasive alternative to surgical removal of adenomas, including large-size tumors (1,32,34,44) , intramucosal carcinoma, and minimally invasive submucosal carcinoma (13,29,38) . Furthermore, Tanaka et al (47) reported that well-or moderately differentiated carcinomas within 1,500 µm invasion are curative by EMR, provided that no vascular involvement is observed.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic mucosal resection in colorectal lesion: a safe and effective procedure even in lesions larger than 2 cm and in carcinomas

Santos¹,

Malaman²,

Pereira-Lima

2011

Arq. Gastroenterol.

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-Context -Endoscopic mucosal resection is a minimally invasive technique used in the treatment of colorectal neoplasms, including early carcinomas of different size and morphology. Objectives -To evaluate procedure safety, efficacy, outcomes, and recurrence rate in endoscopic mucosal resection of colorectal lesions. Methods -A total of 172 lesions in 156 patients were analyzed between May 2003 and May 2009. All lesions showed pit pattern suggestive of neoplasia (Kudo types III-V) at high-magnification chromocolonoscopy with indigo carmine. The lesions were evaluated for macroscopic classification, size, location, and histopathology. Lesions 20 mm or smaller were resected en bloc and lesions larger than 20 mm were removed using the piecemeal technique.Complications and recurrence were analyzed. Patients were followed up for 18 months. Results -There were 83 (48.2%) superficial lesions, 57 (33.1%) depressed lesions, 44 (25.6%) laterally spreading tumors, and 45 (26.2%) protruding lesions. Mean lesion size was 11.5 mm ± 9.6 mm (2 mm-60 mm). Patients' mean age was 61.6 ± 12.5 years (34-93 years). Regarding lesion site, 24 (14.0%) lesions were located in the rectum, 68 (39.5%) in the left colon, and 80 (46.5%) in the right colon (transverse, ascending, and cecum). There were 167 (97.1%) neoplasms: 142 (82.5%) adenomatous lesions, 24 (14.0%) intramucosal carcinomas, and 1 (0.6%) invasive carcinoma. En bloc resection was performed in 158 (91.9%) cases and piecemeal resection in 14 (8.1%). Bleeding occurred in 5 (2.9%) cases. Recurrence was observed in 4.1% (5/122) of cases and was associated with lesions larger than 20 mm (P<0.01), piecemeal resection (P<0.01), advanced neoplasm (P = 0.01), and carcinoma compared to adenoma (P = 0.04). Conclusions -Endoscopic mucosal resection of colorectal lesions is a safe and effective procedure, with low complication and local recurrence rates. Recurrence is associated with lesions larger than 20 mm and carcinomas.

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EMR for Colorectal Lesions

Repici¹,

de²,

Luigiano³

et al. 2008

Endoscopic Mucosal Resection

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Endoscopic Mucosal Resection for Colonic Non-polypoid Neoplasms

Abstract: EMR by using pure cutting current and hemoclip is a useful method for obtaining integral specimen for accurate pathologic assessment. This method provides a safe and minimally invasive technique managing of colonic non-polypoid lesions.

Cited by 48 publications

References 26 publications

Efficacy, Safety and Outcomes of ‘Inject and Cut’ Endoscopic Mucosal Resection for Large Sessile and Flat Colorectal Polyps

Efficacy, Safety and Outcomes of ‘Inject and Cut’ Endoscopic Mucosal Resection for Large Sessile and Flat Colorectal Polyps

Endoscopic mucosal resection in colorectal lesion: a safe and effective procedure even in lesions larger than 2 cm and in carcinomas

EMR for Colorectal Lesions

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