Long-term outcomes and surveillance timing of patients with large non-pedunculated colorectal polyps with histologically incomplete resection in endoscopic resection View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-03-10

AUTHORS

Dong Ku Kang, Su Bum Park, Hyung Wook Kim, Dae Hwan Kang, Cheol Woong Choi, Su Jin Kim, Hyeong Seok Nam, Dae Gon Ryu, Jeong Seok Lee

ABSTRACT

BackgroundHistologically incomplete resection of large colorectal polyps is frequently encountered; however, the long-term outcomes or surveillance timing is not well known. We evaluated the incidence rate and time of recurrence of these cases during a long-term follow-up.MethodsWe performed a retrospective analysis of patients who underwent endoscopic resection for large (≥10 mm in size) non-pedunculated colorectal polyps at a tertiary academic hospital. Patients who had positive or indeterminate lateral margin in the histology and underwent completed surveillance colonoscopy first at 3–12 months and finally at ≥2 years after initial resection were included.ResultsOf 169 polyps (148 patients), 37 (21.9%) and 132 (78.1%) polyps had positive and indeterminate lateral margins, respectively. The median time intervals of the first and last surveillance from the initial resection were 6 (3–12) and 48 (24–114) months, respectively. The recurrence rate was 9.5% (16/169) during follow-up, and the mean time to recurrence was 31.9 months. Thirteen (81.3%) polyps recurred after ≥12 months. Most (14/16, 87.5%) recurrent polyps were benign, and 2 cases had advanced cancer. The only factor that was significantly associated with recurrence in the univariate and multivariate analyses was ≥3 piecemeal resections (odds ratio in the multivariate analysis, 16.92; 95% CI, 1.19–241.81; p = 0.037).ConclusionDuring the long-term follow-up, the only factor that was significantly associated with recurrence was ≥3 piecemeal resections, and most recurrences occurred after ≥12 months. Thus, a histologically incomplete resection with ≤2 piecemeal resections and no findings of suspected submucosal cancer may be considered as complete resection, and these patients may undergo first surveillance colonoscopy after 1–2 years. More... »

PAGES

1369-1378

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-021-08419-9

DOI

http://dx.doi.org/10.1007/s00464-021-08419-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1136272080

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33689013


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