Endoscopy 2019; 51(04): S209
DOI: 10.1055/s-0039-1681791
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Colon and rectum ePosters
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC MUCOSAL RESECTION OF LARGE COLORECTAL LESIONS BY LOW-VOLUME ENDOSCOPISTS: A RETROSPECTIVE STUDY

CI Puscasu
1   Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania
,
R Oprea
1   Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania
,
A Mihai Voiosu
1   Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania
,
A Bengus
1   Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania
,
B Radu Mateescu
1   Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania
2   Internal Medicine, UMF Carol Davila School of Medicine, Bucharest, Romania
,
TA Voiosu
1   Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania
2   Internal Medicine, UMF Carol Davila School of Medicine, Bucharest, Romania
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

In expert hands, endoscopic mucosal resection (EMR) is a safe and effective method for managing superficial neoplastic lesions of the lower GI tract. We aimed to evaluate the technical outcome and safety of colon EMR performed by endoscopists with limited experience in advanced resection techniques.

Methods:

We conducted a single center, retrospective analysis of data collected from patients with sessile/flat polyps, treated over a 24 month period in our unit. We reviewed data regarding the size, localization and morphological characteristics of the lesions, en bloc resection rates, complications and local recurrence during follow-up.

Results:

47 lesions were resected in 41 patients with a mean age of 65+/-19.3years. The median size of the lesion was 20 mm. Most lesions had Paris IIa morphology (48.9%). High grade dysplasia was reported in 6/47 (12.8%) of cases – all males, and advanced neoplasia (TIS and invasive carcinoma) was detected in an additional 6/47 (12.8%) of cases – 5 lesions having mixed morphology (IsIIa). Complete resection of all visible tissue was achieved in 45/47 (95.7%) of cases, but only 9/47 (19.1%) of resections were en-bloc. In 2 cases, plasma argon coagulation for ablation of residual adenomatous tissue was performed in the same session, following piecemeal EMR. 9 patients required a second intervention for recurrent adenoma at follow-up endoscopy, with 6 cases undergoing repeat EMR and 1 patient referred for surgical resection of invasive carcinoma. There were a total of 5 reported adverse events (10.6%) – 3 intra-procedural bleedings, 1 delayed bleeding and 1 perforation, all managed successfully by endoscopy.

Conclusions:

Our study showed that high technical success rates for colon EMR are achievable even by endoscopists with limited initial experience in resection techniques, with low rates of procedure-related adverse events, comparable to those cited in expert centers.