Endoscopic Mucosal Resection for Colonic Mucosal Neoplasia and Evaluation of Long-Term Recurrence: A Single-Center Experience of 500 Cases. Issue 4 (April 2021)

• Record Type: Journal Article
• Authors: Ali, Saeed; Khetpal, Neelam; Idrisov, Evgeny; Rahman, Asad Ur; Khalid, Sameen; Du, Yuan; Navaneethan, Udayakumar; Varadarajulu, Shyam; Hawes, Robert; Hasan, Muhammad Khalid
• Is Part Of: Southern medical journal. Volume 114:Issue 4(2021)
• Publication Date: 2021-04
• Subjects: endoscopic mucosal resection -- laterally spreading lesions -- recurrence; Medicine -- Periodicals; 610.5
• DOI: 10.14423/SMJ.0000000000001234
• Languages: English
• ISSNs: 0038-4348

Abstract

Abstract: Objectives: Endoscopic mucosal resection (EMR) is an alternative to surgery for the treatment of large laterally spreading lesions. Residual or recurrent adenoma is a major limitation. This study aimed to quantify early and late recurrences and to assess its associated risk factors. Methods: The study was a single-center, multiendoscopist, longitudinal study conducted between January 1, 2013 and April 26, 2017. A total of 480 patients with 500 polyps who underwent an endoscopic resection were included. Surveillance colonoscopy (SC) was performed at 4 to 6 months (SC1) and 16 to 18 months (SC2). Results: At SC1, early recurrence was noted in 77 of 354 (21.8%) lesions; 76 (98.7%) were treated endoscopically. The remaining 277 of 354 (78.2%) lesions had no recurrence at SC1; only 41 lesions (15%) were followed up at SC2. Recurrence at SC2 was found in 4 lesions (9.8%), all of which were treated endoscopically. Lesion size >40 mm was associated with recurrence. Recurrence at both SC1 and SC2 was successfully treated endoscopically in 78 of 81 lesions (96.3%). Conclusions: EMR is an effective, minimally invasive technique for the treatment of large laterally spreading lesions. Although recurrence is a concern, its risk is low (21.8% on SC1 and 9.8% on SC2) and was managed endoscopically in 96.3% cases on follow-up endoscopy. Abstract : Endoscopic mucosal resection of large colon polyps is an effective alternative to surgery. This study highlights the safety and efficacy of endoscopic mucosal resection for large laterally spreading colon polyps and quantifies the rate of complications and the risk factors associated with recurrence.Supplemental digital content is available in the text.