Endoscopy 2018; 50(04): S78
DOI: 10.1055/s-0038-1637258
ESGE Days 2018 oral presentations
21.04.2018 – Colon: endoscopic resection session 2
Georg Thieme Verlag KG Stuttgart · New York

RISK FACTORS FOR INCOMPLETE ENDOSCOPIC MUCOSAL RESECTION OF LARGE COLORECTAL POLYPS: PARIS IS-II

M Alburquerque Miranda
1   Hospital de Palamós, Gastroenterology, Girona, Spain
2   Clínica Girona, Gastroenterology, Girona, Spain
,
A Vargas García
1   Hospital de Palamós, Gastroenterology, Girona, Spain
2   Clínica Girona, Gastroenterology, Girona, Spain
,
I Sánchez Pérez
3   Hospital de Palamós, Research, Girona, Spain
,
A Smarrelli
1   Hospital de Palamós, Gastroenterology, Girona, Spain
,
C Ledezma Frontado
1   Hospital de Palamós, Gastroenterology, Girona, Spain
,
L Vidal Plana
1   Hospital de Palamós, Gastroenterology, Girona, Spain
,
M Figa Francesc
2   Clínica Girona, Gastroenterology, Girona, Spain
4   Hospital Universitari de Girona Dr. Josep Trueta, Gastroenterology, Girona, Spain
,
F González-Huix Lladó
2   Clínica Girona, Gastroenterology, Girona, Spain
5   Hospital Universitari Arnau de Vilanova, Gastroenterology, Lleida, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

Also available at
 

Aims:

To determine risk factors for incomplete endoscopic mucosal resection (EMRi) of colorectal sessile (Is) and/or flat (II) polyps ≥20 mm, according to the polyp features and EMR.

Methods:

Prospective cohort study done in two centres from 2010 to 2017. Minimum sample size: 140 polyps according to principal effects model. There were included lesions with endoscopist's perception of complete EMR and follow up within 3 to 6 months. We defined EMRi as the presence of remains of polyp in follow up colonoscopy.

Results:

From 327 resected lesions there were included 270 (261 patients, age: 65,8 ± 10,4 years, 42,1% women). Exclusion reason: no follow up. The 84,8% of EMR were performed by expert endoscopists. Length of follow up: 5,1 ± 5,3 months. EMRi rate: 18,9%; 94,1% of residual polyps were resected during endoscopic follow up. Lesions: 37,4% Is, 68,5% II, 31,1% IIa + IIc, 71,4% LST-G; 28,0 ± 10,4 mm in size; 44,4% located in right colon and 72,2% with advanced histology (AH). The 89,6% of lesions were resected en 1 colonoscopy through piecemeal EMR in 72,6%. Either APC or electrocoagulation were used to complete resection in 38,1% and either cold forceps or cold snare in 28,9%. There was intra-procedure bleeding in 21,9% of EMR. The size ≥40 mm (OR = 7,37 (3,19 – 17,04 CI 95%); PR = 6,22), pure flat form (OR: 2,26 (1,07 – 4,77 CI 95%); PR = 2,18) and AH (OR = 3,21 (1,15 – 9,02 CI 95%); PR = 3,02) were associated to EMRi.

Conclusions:

The size ≥40 mm, pure flat form and advanced histology are risk factors for incomplete endoscopic mucosal resection of colorectal sessile (Is) and/or flat (II) polyps ≥20 mm. Overall, over 94% of residual polyps are completely resected during endoscopic follow up.