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Hong YM, Kim HW, Park SB, et al. Endoscopic mucosal resection with circumferential incision for the treatment of large sessile polyps and laterally spreading tumors of the colorectum. Clin Endosc. 2015;48(1):52-8doi: 10.5946/ce.2015.48.1.52.
Hong, Y. M., Kim, H. W., Park, S. B., Choi, C. W., & Kang, D. H. (2015). Endoscopic mucosal resection with circumferential incision for the treatment of large sessile polyps and laterally spreading tumors of the colorectum. Clinical endoscopy, 48(1), 52-8. https://doi.org/10.5946/ce.2015.48.1.52
Hong, Young Mi, et al. "Endoscopic mucosal resection with circumferential incision for the treatment of large sessile polyps and laterally spreading tumors of the colorectum." Clinical endoscopy vol. 48,1 (2015): 52-8. doi: https://doi.org/10.5946/ce.2015.48.1.52
Hong YM, Kim HW, Park SB, Choi CW, Kang DH. Endoscopic mucosal resection with circumferential incision for the treatment of large sessile polyps and laterally spreading tumors of the colorectum. Clin Endosc. 2015 Jan;48(1):52-8. doi: 10.5946/ce.2015.48.1.52. Epub 2015 Jan 31. PMID: 25674527; PMCID: PMC4323433.
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Clin Endosc. 2015 Jan;48(1):52-8. doi: 10.5946/ce.2015.48.1.52. Epub 2015 Jan 31.

Endoscopic mucosal resection with circumferential incision for the treatment of large sessile polyps and laterally spreading tumors of the colorectum.

Clinical endoscopy

Young Mi Hong, Hyung Wook Kim, Su Bum Park, Cheol Woong Choi, Dae Hwan Kang

Affiliations

  1. Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

PMID: 25674527 PMCID: PMC4323433 DOI: 10.5946/ce.2015.48.1.52

Abstract

BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) is the standard treatment for colorectal polyps such as adenomas and early cancers with no risk of lymph node metastasis. However, endoscopic resection of large colorectal polyps (≥20 mm diameter) is difficult to perform. We evaluated the clinical outcomes of EMR with circumferential incision (EMR-CI) for the resection of large sessile polyps (Is) and laterally spreading tumors (LSTs) in the colorectum.

METHODS: Between February 2009 and March 2011, we resected 80 large colorectal polyps by EMR-CI. We retrospectively investigated the en bloc resection rate, histologic complete resection rate, recurrence rate, and complications.

RESULTS: The median polyp size was approximately 25 mm (range, 20 to 50), and the morphologic types included Is (13 cases), LST-granular (37 cases), and LST-nongranular (30 cases). The en bloc and complete histologic resection rates were 66.3% and 45.0%, respectively. The recurrence rate was 0% (median follow-up duration, 23 months), and perforation occurred in five cases (6.3%).

CONCLUSIONS: EMR-CI is an effective treatment modality for 20 to 30 mm-sized colorectal polyps, and may be considered as a second line therapeutic option if ESD is difficult.

Keywords: Circumferential incision; Colorectal polyps; Endoscopic mucosal resection

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