Endoscopy 2020; 52(S 01): S245
DOI: 10.1055/s-0040-1704766
ESGE Days 2020 ePoster Podium presentations
Saturday, April 25, 2020 15:30 – 16:00 EMR in colon 5 ePoster Podium 7
© Georg Thieme Verlag KG Stuttgart · New York

CONVENTIONAL ENDOSCOPIC MUCOSAL RESECTION VS. PRECUT-ENDOSCOPIC MUCOSAL RESECTION FOR LARGE (≥ 1 CM) COLORECTAL LESIONS WITH ENDOSCOPIC FEATURES OF SESSILE SERRATED ADENOMA/POLYP

CK Oh
1   Seoul St. Mary’s Hospital, The Catholic University of Korea, Division of Gastroenterology, Department of Medicine, Seoul, Korea, Republic of
,
BI Lee
1   Seoul St. Mary’s Hospital, The Catholic University of Korea, Division of Gastroenterology, Department of Medicine, Seoul, Korea, Republic of
,
SH Lee
2    Seoul St. Mary’s Hospital, The Catholic University of Korea, Departments of Hospital Pathology, Seoul, Korea, Republic of
,
SJ Kim
1   Seoul St. Mary’s Hospital, The Catholic University of Korea, Division of Gastroenterology, Department of Medicine, Seoul, Korea, Republic of
,
HH Lee
1   Seoul St. Mary’s Hospital, The Catholic University of Korea, Division of Gastroenterology, Department of Medicine, Seoul, Korea, Republic of
,
JM Park
1   Seoul St. Mary’s Hospital, The Catholic University of Korea, Division of Gastroenterology, Department of Medicine, Seoul, Korea, Republic of
,
YS Cho
1   Seoul St. Mary’s Hospital, The Catholic University of Korea, Division of Gastroenterology, Department of Medicine, Seoul, Korea, Republic of
,
IS Lee
1   Seoul St. Mary’s Hospital, The Catholic University of Korea, Division of Gastroenterology, Department of Medicine, Seoul, Korea, Republic of
,
MG Choi
1   Seoul St. Mary’s Hospital, The Catholic University of Korea, Division of Gastroenterology, Department of Medicine, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Interval colorectal cancers can result from an incompletely resected lesion. Sessile serrated adenomas/polyps (SSA/Ps) were more likely to be incompletely resected than conventional adenomas. Precut endoscopic mucosal resection (EMR-P) is a method for improving complete and en bloc resection rate of large gastrointestinal neoplasia.

Methods Retrospective analysis was performed for resection of large (≥ 1 cm) colorectal lesions with endoscopic features of SSA/P (a pale or normal-colored flat lesion with indistinctive border, mucus cap, cloud-like surface, rim of debris, and dilated crypts) in Seoul St. Mary’s Hospital from January 2014 to July 2019.

Results Among 615 eligible lesions with endoscopic features of SSA/P, 359 lesions in conventional endoscopic resection (EMR) group and 161 lesions in EMR-P group were included in the study. 95 lesions were excluded because of non-neoplastic histopathology, less-experienced operators, or missing data. The mean size of the lesions was 12.8 ± 3.8 mm and 15.6 ± 4.4 mm (P < 0.001) and en bloc resection rate was 90.5% in EMR group and 91.9% in EMR-P group (P = 0.608), respectively. R0 resection rate was significantly higher in EMR-P group compared to EMR group (89.4% vs. 64.3%, P< 0.001) and median procedure time was significantly longer in the EMR-P group compared to EMR group (492.4 ± 336.3 sec vs. 182.3 ± 137.8 sec, P < 0.001). Two delayed perforations occurred in the EMR-P group. In univariate analysis, EMR-P, en bloc resection, morphology and right side lesions were significantly associated with R0 resection. In multivariate analysis, EMR-P, right side lesions were significantly associated with R0 resection. During the median follow-up of 21.9 ± 12.1 months, 3 recurrences occurred in the EMR group only (P = 0.561).

Conclusions EMR-P is superior to EMR for R0 resection of large colorectal lesions with endoscopic features of SSA/P although significantly longer procedure time is required for EMR-P.