| Endoscopic mucosal resection for large and giant sessile and flat colorectal polyps: a single-center experience with long-term follow-up. | |
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MedLine Citation:
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PMID: 19750448 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND STUDY AIMS: This study examines efficacy, outcome, and complications of endoscopic mucosal resection (EMR) for large (> or = 20 mm) and giant (> or = 40 mm) sessile and flat colorectal polyps. PATIENTS AND METHODS: All EMRs carried out at our institution over a 9-year period, for large and giant sessile and flat colorectal polyps with an intensive and regular follow-up were evaluated. The rate of en bloc and piecemeal resection, complications, and recurrence were analyzed. RESULTS: A total of 148 polyps were resected in 148 patients. There were 113 large polyps (76.3 %) with a mean size of 25 +/- 4.7 mm (range 20 - 39 mm) and 35 giant polyps (23.7 %) with a mean size of 48.8 +/- 12.5 mm (range 40 - 100 mm). The most frequent location was the rectum, occurring in 43.2 %. All lesions were removed in a single session. En bloc resection was performed in 65 cases (43.9 %) and piecemeal in 83 (56.1 %). Procedural bleeding occurred in 13 EMRs (8.8 %), and one case of early and one case of delayed bleeding also occurred. There were two cases of postpolypectomy syndrome and one case of perforation. Malignancy (intramucosal and invasive cancer) was mostly present in polyps with sessile shape ( P = 0.0013). Follow-up colonoscopy was performed in 142 patients for a mean of 29.8 months. Recurrence was observed in 6/142 (4.2 %) patients and was found more in patients with giant polyps ( P = 0.014). CONCLUSIONS: In our experience EMR is a simple and safe procedure for removing large and giant sessile and flat colorectal polyps, and is associated with a very low risk of complication and local recurrence. |
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Authors:
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C Luigiano; P Consolo; M G Scaffidi; G Strangio; G Giacobbe; A Alibrandi; S Pallio; A Tortora; G Melita; L Familiari |
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Publication Detail:
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Type: Evaluation Studies; Journal Article Date: 2009-09-11 |
Journal Detail:
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Title: Endoscopy Volume: 41 ISSN: 1438-8812 ISO Abbreviation: Endoscopy Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-02 Completed Date: 2010-02-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0215166 Medline TA: Endoscopy Country: Germany |
Other Details:
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Languages: eng Pagination: 829-35 Citation Subset: IM |
Copyright Information:
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Georg Thieme Verlag KG Stuttgart. New York. |
Affiliation:
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Department of Medicine and Pharmacology, University Hospital G. Martino, Messina 98100, Italy. carmeluigiano@libero.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Colonic Polyps / pathology, surgery Endoscopy, Gastrointestinal Female Follow-Up Studies Humans Intestinal Mucosa / surgery* Intestinal Polyps / pathology, surgery* Male Middle Aged Polyps / pathology, surgery* Rectal Diseases / pathology, surgery* Recurrence Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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