Endoscopy 2022; 54(05): 509-514
DOI: 10.1055/a-1559-2391
Innovations and brief communications

Efficacy and safety of cap-assisted endoscopic mucosal resection for treatment of nonlifting colorectal polyps

1   Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands
,
Leon M. G. Moons
1   Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands
,
Wilmar de Graaf
2   Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, Netherlands
,
Ruud W. M. Schrauwen
3   Department of Gastroenterology and Hepatology, Bernhoven Hospital, Uden, Netherlands
,
Wouter L. Hazen
4   Department of Gastroenterology and Hepatology, Elisabeth-Twee Steden Hospital, Tilburg, Netherlands
,
Tom C. J. Seerden
5   Department of Gastroenterology and Hepatology, Amphia Hospital, Breda, Netherlands
,
Frank P. Vleggaar
1   Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands
,
Paul Didden
1   Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands
› Author Affiliations


Abstract

Background Suboptimal lifting increases complexity of endoscopic mucosal resection (EMR) for benign colorectal polyps. Cap-assisted EMR (EMR-C) may allow fibrotic polyp tissue to be captured in the snare. This study evaluated the efficacy and safety of EMR-C for benign nonlifting colorectal polyps.

Methods This was a multicenter study, which prospectively registered all EMR-C procedures (2016–2018) for presumed benign nonlifting colorectal polyps.

Results 70 nonlifting polyps with a median size of 25 mm (interquartile range [IQR] 15–40) were treated with EMR-C. Complete polyp removal was achieved in 68 (97.1 %), including 47 (67.1 %) with EMR-C alone. Overall, 66 polyps showed benign histology, and endoscopic follow-up after a median of 6 months (IQR 6–10) showed recurrence in 19.7 %. First (n = 10) and second (n = 2) benign recurrences were all treated endoscopically. Deep mural injury type III–V occurred in 7.4 % and was treated successfully with clips.

Conclusion EMR-C may be an alternative therapeutic option for removal of benign nonlifting polyp tissue. Although recurrence still occurs, repeat endoscopic therapy usually leads to complete polyp clearance.

Appendix 1 s, Fig. 1 s, Tables 1 s, 2 s



Publication History

Received: 12 November 2020

Accepted after revision: 03 July 2021

Publication Date:
14 September 2021 (online)

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