scholarly journals INCREASED RISK OF SYNCHRONOUS COLORECTAL LESIONS IN PATIENTS REFERRED FOR ENDOSCOPIC MUCOSAL RESECTION OF LATERAL SPREADING TUMORS

2019 ◽  
Vol 56 (3) ◽  
pp. 276-279 ◽  
Author(s):  
Maria Constanza TORELLA ◽  
Belén DUARTE ◽  
Mariano VILLARROEL ◽  
Juan LASA ◽  
Ignacio ZUBIAURRE
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Bowel Preparation ◽  
Lateral Spreading ◽  
Serrated Adenoma ◽  
Index Lesion ◽  
Mucosal Resection ◽  
Increased Risk ◽  
Lateral Spreading Tumor ◽  
Serrated Adenomas ◽  
Synchronous Lesion

ABSTRACT BACKGROUND: Endoscopic mucosal resection is one of the most frequent therapeutic alternatives for large colorectal lateral spreading tumors. There are few data on the prevalence of synchronous lesions on these patients. OBJECTIVE: To describe the prevalence of synchronous colorectal lesions in patients referred for endoscopic mucosal resection of lateral spreading tumors >20 mm. METHODS: We reviewed the endoscopic database of our Department and identified adult patients who were referred for the resection of a colorectal lateral spreading tumor >20 mm and had a diagnostic colonoscopy performed up to six months before. The proportion of patients with at least one synchronous lesion was estimated. The following features were compared between patients with and without synchronous lesions: age, gender, bowel preparation quality and cecal intubation on index colonoscopy and therapeutic colonoscopy, serrated adenoma as index lesion. RESULTS: From December 2016 to November 2017, we identified 70 patients who fulfilled inclusion criteria. Median size of lesions was 25 mm (20-45). Eighty percent were located in the right colon and 35.71% were serrated adenomas. Synchronous lesion rate was 38.57%. Bowel preparation quality was similar in both groups when comparing both index and therapeutic colonoscopies. Patients with synchronous lesions had a higher proportion of serrated adenoma as index lesion than patients without synchronous lesions [51.85% vs 25.58%, OR 3.13 (1.13-8.68), P=0.03]. CONCLUSION: We found a high prevalence of synchronous lesions among patients with a large colorectal lateral spreading tumor. This risk seems to be increased if index lesions are serrated adenomas.

Underwater endoscopic mucosal resection of recurrent duodenal lateral spreading tumor

Endoscopy ◽  
2020 ◽  
Author(s):  
Mariano Villarroel ◽  
Hugo Bilder ◽  
Belen Duarte ◽  
Juan Lasa ◽  
Ignacio Zubiaurre
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Lateral Spreading ◽  
Mucosal Resection ◽  
Lateral Spreading Tumor

Sp956 Appendiceal Orifice Stenting after Endoscopic Mucosal Resection of a Colon Lateral Spreading Tumor

2012 ◽  
Vol 75 (4) ◽  
pp. AB111
Author(s):  
Gene Hyun Bok ◽  
Won Young Cho ◽  
Joo Young Cho ◽  
Kwang Yeun Shim ◽  
Wook Hyun Um
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Lateral Spreading ◽  
Mucosal Resection ◽  
Lateral Spreading Tumor

scholarly journals Underwater endoscopic mucosal resection of serrated adenomas

Clinics ◽  
2018 ◽  
Vol 73 ◽  
Author(s):  
DM Chaves ◽  
HP Brito ◽  
LT Chaves ◽  
RA Rodrigues ◽  
BM Sugai
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Mucosal Resection ◽  
Serrated Adenomas

scholarly journals Colorectal endoscopic mucosal resection with submucosal injection of epinephrine versus hypertonic saline in patients taking antithrombotic agents: propensity-score-matching analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Daisuke Yamaguchi ◽  
Hisako Yoshida ◽  
Kei Ikeda ◽  
Yuki Takeuchi ◽  
Shota Yamashita ◽  
...  
Keyword(s):  
Propensity Score ◽  
Adverse Events ◽  
Propensity Score Matching ◽  
Endoscopic Mucosal Resection ◽  
Hypertonic Saline ◽  
Colon Polyps ◽  
Antithrombotic Agents ◽  
Submucosal Injection ◽  
Mucosal Resection ◽  
Increased Risk

Abstract Background Endoscopic mucosal resection (EMR) to remove colon polyps is increasingly common in patients taking antithrombotic agents. The safety of EMR with submucosal saline injection has not been clearly demonstrated in this population. Aims The present study aimed to evaluate the efficacy and safety of submucosal injection of saline–epinephrine versus hypertonic saline in colorectal EMR of patients taking antithrombotic agents. Methods This study enrolled 204 patients taking antithrombotic agents among 995 consecutive patients who underwent colonic EMR from April 2012 to March 2018 at Ureshino Medical Center. Patients were divided into two groups according to the injected solution: saline–epinephrine or hypertonic (10%) saline (n = 102 in each group). Treatment outcomes and adverse events were evaluated in each group and risk factors for immediate and post-EMR bleeding were investigated. Results There were no differences between groups in patient or polyp characteristics. The main antithrombotic agents were low-dose aspirin, warfarin, and clopidogrel. Propensity-score matching created 80 matched pairs. Adjusted comparisons between groups showed similar en bloc resection rates (95.1% with saline–epinephrine vs. 98.0% with hypertonic saline). There were no significant differences in adverse events (immediate EMR bleeding, post-EMR bleeding, perforation, or mortality) between groups. Multivariate analyses revealed that polyp size over 10 mm was associated with an increased risk of immediate EMR bleeding (odds ratio 12.1, 95% confidence interval 2.0–74.0; P = 0.001). Conclusions Two tested solutions in colorectal EMR were considered to be both safe and effective in patients taking antithrombotic agents.

scholarly journals Use of an additional working channel for endoscopic mucosal resection (EMR +)of a pedunculated sessile serrated adenoma in the sigmoid colon

Endoscopy ◽  
2019 ◽  
Vol 51 (03) ◽  
pp. 279-280 ◽  
Author(s):  
Edris Wedi ◽  
Richard Knoop ◽  
Carlo Jung ◽  
Volker Ellenrieder ◽  
Steffen Kunsch
Keyword(s):  
Sigmoid Colon ◽  
Endoscopic Mucosal Resection ◽  
Sessile Serrated Adenoma ◽  
Serrated Adenoma ◽  
Mucosal Resection

scholarly journals Endoscopic mucosal resection of colorectal tumors: Our first experience

2011 ◽  
Vol 68 (9) ◽  
pp. 744-748 ◽  
Author(s):  
Aleksandar Nagorni ◽  
Goran Bjelakovic
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Interventional Procedure ◽  
Lateral Spreading ◽  
Minimal Invasive ◽  
Colorectal Adenomas ◽  
Everyday Practice ◽  
Early Colorectal Cancer ◽  
Colorectal Tumors ◽  
Mucosal Resection ◽  
Advanced Adenomas

Background/Aim. Endoscopic mucosal resection (EMR) or mucosectomy is an interventional procedure for minimal invasive endoscopic removal of benign and malignant digestive tract tumors. Mucosectomy removes flat and sessile neoplasms, early colorectal cancer (CRC) confined to mucosa or submucosa and lateral spreading tumors. The aim of the study was to show our first experience in application of this procedure in everyday practice in regarding completeness and efficacy of the procedure, complication rate and incidence of recurrent adenomas. Methods. In the prospective study 51 colorectal adenomas were removed in 44 patients by EMR. Results. Single mucosectomy was done in 43 patients, while multiple (8) in one patient. Complete resection was obtained in all procedures. In 36 (68.62%) procedures ?en block? resection was done, but in 15 (31.37%) procedures ?piece meal? resection was performed. Synchronous colorectal tumors (benign or malignant) were detected in 20 (45.45%) patients. Moderate dysplasia was found in 30 (58.82%) adenomas, but high grade dysplasia in 9 (17.64%) of adenomas. Intramucosal CRC was detected in 11.77% of adenomas. A total of 37 (72.54%) advanced adenomas were removed. There were 3 (5.88%) of recurrent adenomas, 6-30 months after the EMR. Only one (2.2%) case of post procedure bleeding was observed. Conclusion: EMR is a safe and efficious method for removal of flat, sessile adenomas, as well as early CRC. EMR is a routine endoscopic procedure in everyday practice of interventional endoscopist.

Sign in / Sign up

Export Citation Format

Share Document