Endoscopy 2019; 51(04): S219
DOI: 10.1055/s-0039-1681825
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Colon and rectum ePosters
Georg Thieme Verlag KG Stuttgart · New York

APPLICATION IN OUR CENTER OF THE CLINICAL GUIDE FOR ENDOSCOPIC RESECTION OF COLON POLYPS IN THE MANAGEMENT OF ADENOCARCINOMA PT1

A Glez-Cotorruelo Glez
1   Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
,
A Álvarez Delgado
1   Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
,
AM Soler
1   Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
,
AB Prieto Bermejo
1   Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
,
A Jiménez Jurado
1   Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
,
M Garcia Prada
1   Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
,
ÁF Marcos Martin
1   Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
,
P Rodríguez López
1   Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
,
S Del Carmen Martínez
1   Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
,
A Rodríguez Pérez
1   Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

The pT1 adenocarcinoma resected endoscopically poses a challenge in terms of its management. In some cases, there is a lack of scientific evidence that supports the need of additional invasive treatments. The Spanish Society of digestive Endoscopy suggests the classification of these injuries according to the risk of dissemination, multidisciplinary advice and individualized decision for patients at intermediate/high risk.

Methods:

A descriptive, prospective study analyzing the follow-up in our center of patients undergoing endoscopic resection of pT1 adenocarcinoma between January 2015 and June 2018.

Results:

138 patients, 96 men (69.6%), with an average age of: 68.42 +/- 9.75 years and an average follow-up time of 20.96 ± 10.76 months. The most frequent reason for the indication of a colonoscopy was a positive SOH test within the CCR screening program: 68 (49.3%). The average size of the injuries was 22.36 ± 11.54 mm; 75 (54%) were Paris 0-Ip. In 114 (82.6%) polypectomy was performed in bulk. We described 2 perforations (1.4%) and 17 haemorrhages (12.31%) all endoscopically solved. We classified in risk groups according to the guide of resection polyps of the Spanish Society of digestive Endoscopy: 67 (48.6%) of low risk, 22 (15.9%) intermediate risk, 39 (28.3%) high risk and 10 (7.2%) resection incomplete. We analyzed the medium-high risk subgroup, after the multidisciplinary committee, 40 (65.57%) were included in the endoscopic surveillance and 19 (31.14%) were operated. Of the patients operated, in 5 (26.31%) the histology of the surgical piece was positive, without significant relationship with any parameter of poor prognosis analyzed. In the endoscopic follow-up, 4 presented recurrence results, resolved by endoscopy.

Conclusions:

In our series, the management suggested by the Spanish Society digestive Endoscopy seems adequate, in absence of confirmation of results with longer follow-up and larger sample size.