HOT AVULSION TECHNIQUE – A FIRST LINE APPROACH FOR TREATMENT OF VISIBLE RESIDUAL NEOPLASIA DURING ENDOSCOPIC MUCOSAL RESECTION OF COLORECTAL POLYPS?

Aims:

The aim of this study was to evaluate the efficacy and safety of HA at index EMR and at EMR local recurrence.

Methods:

We did a retrospective study based on all the HA performed between June 2015 and February 2017. The endoscopic characteristics, complications and recurrence rate after the initial HA were evaluated.

Results:

33 HA were performed among 29 patients (16 men and 13 women) with an average age of 69 years. The average follow-up time was 11 months. HA was used to remove residual adenomatous tissue at 17 index EMR (mean size of the lesion 30 mm) and to remove recurrent fibrotic adenomatous tissue at EMR scar in 12 cases (mean size of recurrence tissue 14 mm). HA was successful in removing residual/recurrent adenomatous tissue in all patients. There were no immediate or long term adverse events. Comparing the two groups, local recurrence after initial HA occurred in one case at the index EMR group (1/17) and in 2 cases at the local EMR recurrence group (2/12). The overall recurrence rate in patients with a minimum 6 months follow up was 15% (3/20).

Conclusions:

HA is a safe and effective technique to eradicate both residual tissue in large colorectal adenomas and recurrent fibrotic adenomatous tissue at EMR site, with low recurrence rate.