EMR of large sessile colorectal polyps☆
Section snippets
Patients
An uncontrolled prospective study was conducted of a cohort of patients with known large sessile colorectal polyps who were referred for EMR. Patients were treated in 3 departments of gastroenterology (regional referral centers). All patients were identified by colonoscopy performed in these centers or by colleagues in other hospitals. The study protocol was approved by the institutional review board of our National Institute for Cancer Research. All patients were invited to participate, and
Results
A total of 139 SP were treated by piecemeal EMR in the 136 enrolled patients. Three patients had more than one polyp. The characteristics of the study group and the size and the location of the SP are given in Table 1; 61.9% were in the cecum or ascending colon (RC). The median diameter of SP in the RC was 20 mm and 30 mm (20-100 mm) for those located distal to the RC. A positive correlation was observed between polyp size and patient age (Spearman test, p < 0.0001). The characteristics of the
Discussion
A total of 139 SP, 86 in the RC, were removed in the present study by using one of two EMR techniques with minimal complications. The study was not a randomized comparison of the two techniques. The choice of technique was determined by the morphology of the lesion and its location. Some lesions could only be treated by one of the two methods. The use of piecemeal technique was unavoidable in all instances, because of the large diameter of the lesions and/or the location. Large polyps have been
References (38)
- et al.
Efficacy of colonic submucosal saline solution injection for the reduction of iatrogenic thermal injury
Gastrointest Endosc
(2002) - et al.
Endoscopic therapy for early colon cancer: the strip biopsy resection technique
Gastrointest Endosc
(1991) - et al.
Endoscopic mucosal resction with cap-fitted panendoscope for esophagus, stomach, and colon mucosal lesions
Gastrointest Endosc
(1993) - et al.
Endoscopic submucosal resection of rectal carcinoid tumors with a ligation device
Gastrointest Endosc
(2003) - et al.
Treatment with argon plasma coagulation reduces recurrence after piecemeal resection of large sessile colonic polyps: a randomized trial and recommendations
Gastrointest Endosc
(2002) - et al.
Endoscopic piecemeal resection with submucosal saline injection of large sessile colorectal polyps
Gastrointest Endosc
(2000) - et al.
Endoscopic snare excision of “giant” colorectal polyps
Gastrointest Endosc
(1996) - et al.
Clinicopathologic features and endoscopic treatment of superficially spreading colorectal neoplasms larger than 20 mm
Gastrointest Endosc
(2001) - et al.
Large sessile colonic adenomas: use of argon plasma coagulator to supplement piecemeal snare polypectomy
Gastrointest Endosc
(1999) - et al.
Injection-incision-assisted snare resection of large sessile colorectal polyps
Gastrointest Endosc
(1996)
Colonic mucosal resection using a transparent cap-fitted endoscope
Gastrointest Endosc
Piecemeal snare excision of large sessile colon and rectal polyps: it is adequate?
Gastrointest Endosc
Endoscopic Nd:YAG laser therapy for villous adenomas of the right colon
Gastrointest Endosc
Adenoma size and number are predictive of adenoma recurrence: implications for surveillance colonoscopy
Gastrointest Endosc
Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Work-group
N Engl J Med
Endoscopic resection of large sessile colorectal polyps using a submucosal saline injection technique
Hepato-gastroenterology
Endoscopic mucosal resection of flat and depressed types of early colorectal cancer
Endoscopy
Endoscopic diagnosis and treatment of early colorectal cancer
World J Surg
Endoscopic mucosal resection for colorectal neoplastic lesions
Dis Colon Rectum
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