摘要
Background EMR optimizes histopathologic assessment of resected lesions. This study evaluated the outcome of EMR of large sessile colorectal polyps in terms o f complications and recurrence. Methods An uncontrolled prospective study was co nducted of a cohort of 136 patients with sessile colorectal polyps referred for EMR. After submucosal injection, EMR was performed piecemeal by either snare pol ypectomy alone or with cap aspiration. Results In 136 patients, a total of 139 s essile polypswere resected, 86 ofwhichwere in the right colon.Median polyps diam eter was 20 mm in the right colon and 30 mm in the other colonic segments. Intra procedure bleeding occurred after 15 polypectomies (10.8%) and was controlled e ndoscopically in all cases; there was no delayed bleeding.Post-polypectomy synd rome occurred in 5 patients (3.7%). There was no perforation. Invasive carcinom a was found in 17 sessile colorectal polyps, and surgery was performed in 10 of 17 cases. Follow-up colonoscopy in 93 patients without invasive carcinoma (96 p olyps), over a median of 12.3 months,disclosed local recurrence of 21 adenomatou s polyps (21.9%). Colonoscopic follow-up in 5 of the 7 patients, who had sessi le colorectal polyps with invasive carcinoma and did not undergo surgery, disclo sed no local recurrence. Conclusions EMR, including EMR with cap aspiration, is effective and safe for removal of sessile colorectal polyps throughout the colon .
Background EMR optimizes histopathologic assessment of resected lesions. This study evaluated the outcome of EMR of large sessile colorectal polyps in terms o f complications and recurrence. Methods An uncontrolled prospective study was co nducted of a cohort of 136 patients with sessile colorectal polyps referred for EMR. After submucosal injection, EMR was performed piecemeal by either snare pol ypectomy alone or with cap aspiration. Results In 136 patients, a total of 139 s essile polypswere resected, 86 ofwhichwere in the right colon.Median polyps diam eter was 20 mm in the right colon and 30 mm in the other colonic segments. Intra procedure bleeding occurred after 15 polypectomies (10.8%) and was controlled e ndoscopically in all cases; there was no delayed bleeding.Post-polypectomy synd rome occurred in 5 patients (3.7%). There was no perforation. Invasive carcinom a was found in 17 sessile colorectal polyps, and surgery was performed in 10 of 17 cases. Follow-up colonoscopy in 93 patients without invasive carcinoma (96 p olyps), over a median of 12.3 months,disclosed local recurrence of 21 adenomatou s polyps (21.9%). Colonoscopic follow-up in 5 of the 7 patients, who had sessi le colorectal polyps with invasive carcinoma and did not undergo surgery, disclo sed no local recurrence. Conclusions EMR, including EMR with cap aspiration, is effective and safe for removal of sessile colorectal polyps throughout the colon .
