Tip-in endoscopic mucosal resection for large colorectal sessile polyps View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-04-30

AUTHORS

Yoshinori Sato, Shun-ichiro Ozawa, Hiroshi Yasuda, Masaki Kato, Hirofumi Kiyokawa, Masaki Yamashita, Yasumasa Matsuo, Hiroyuki Yamamoto, Fumio Itoh

ABSTRACT

BackgroundTip-in endoscopic mucosal resection (EMR) is a modified EMR technique using which en bloc resection of large colorectal sessile polyps can be performed; however, its usefulness for colorectal sessile polyps of > 20 mm has not been reported. This study examined treatment outcomes of tip-in and conventional EMR for large colorectal sessile polyps of ≥ 20 mm.MethodsThis was a retrospective case–control study conducted at a single tertiary center in Japan. Subjects included those with large colorectal sessile polyps of ≥ 20 mm, excluding pedunculated-type polyps, who underwent endoscopic resection between January 2010 and January 2019. The primary outcome was endoscopic treatment outcomes when using tip-in and conventional EMR, and the secondary outcome was the local recurrence rate after endoscopic treatment.ResultsForty-three colorectal lesions were treated using tip-in EMR and 83 using conventional EMR. Tip-in EMR had a significantly higher en bloc resection rate (90.7% vs. 69.8.%), and significantly shorter treatment duration (6.64 ± 0.64 min vs. 10.47 ± 0.81 min) than conventional EMR. However, for lesions > 30 mm, en bloc resection rate was 50.0% and 52.6% for tip-in and conventional EMR, respectively, indicating no significant difference. Perforation rates with tip-in and conventional EMR were 4.6% and 3.6%, respectively, indicating no significant difference. Local recurrence was examined in 80 cases who were followed up for > 6 months after endoscopic resection; recurrence rate was 0% and 7.0% in tip-in and conventional EMR cases, respectively, without significance difference.ConclusionsTip-in EMR showed high en-block resection rate, particularly in polyps of < 30 mm, and no residual tumor was found. This technique is a potential endoscopic treatment alternative for large colorectal sessile polyps of ≥ 20 mm. More... »

PAGES

1820-1826

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-020-07581-w

DOI

http://dx.doi.org/10.1007/s00464-020-07581-w

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1127256332

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32356110


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27 schema:description BackgroundTip-in endoscopic mucosal resection (EMR) is a modified EMR technique using which en bloc resection of large colorectal sessile polyps can be performed; however, its usefulness for colorectal sessile polyps of > 20 mm has not been reported. This study examined treatment outcomes of tip-in and conventional EMR for large colorectal sessile polyps of ≥ 20 mm.MethodsThis was a retrospective case–control study conducted at a single tertiary center in Japan. Subjects included those with large colorectal sessile polyps of ≥ 20 mm, excluding pedunculated-type polyps, who underwent endoscopic resection between January 2010 and January 2019. The primary outcome was endoscopic treatment outcomes when using tip-in and conventional EMR, and the secondary outcome was the local recurrence rate after endoscopic treatment.ResultsForty-three colorectal lesions were treated using tip-in EMR and 83 using conventional EMR. Tip-in EMR had a significantly higher en bloc resection rate (90.7% vs. 69.8.%), and significantly shorter treatment duration (6.64 ± 0.64 min vs. 10.47 ± 0.81 min) than conventional EMR. However, for lesions > 30 mm, en bloc resection rate was 50.0% and 52.6% for tip-in and conventional EMR, respectively, indicating no significant difference. Perforation rates with tip-in and conventional EMR were 4.6% and 3.6%, respectively, indicating no significant difference. Local recurrence was examined in 80 cases who were followed up for > 6 months after endoscopic resection; recurrence rate was 0% and 7.0% in tip-in and conventional EMR cases, respectively, without significance difference.ConclusionsTip-in EMR showed high en-block resection rate, particularly in polyps of < 30 mm, and no residual tumor was found. This technique is a potential endoscopic treatment alternative for large colorectal sessile polyps of ≥ 20 mm.
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36 Japan
37 MethodsThis
38 Secondary outcomes
39 alternative
40 bloc resection
41 bloc resection rate
42 case-control study
43 cases
44 center
45 colorectal lesions
46 conventional endoscopic mucosal resection
47 differences
48 duration
49 en bloc resection
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51 endoscopic mucosal resection
52 endoscopic resection
53 endoscopic treatment
54 endoscopic treatment outcomes
55 lesions
56 local recurrence
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58 months
59 mucosal resection
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63 primary outcome
64 rate
65 recurrence
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67 resection
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70 retrospective case-control study
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73 significance difference
74 significant differences
75 single tertiary center
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