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Endoscopy 2010; 42(10): 806-813
DOI: 10.1055/s-0030-1255715
Original article

© Georg Thieme Verlag KG Stuttgart · New York

A national survey of endoscopic mucosal resection for superficial gastrointestinal neoplasia

D.  Heresbach1 , R.  Kornhauser1 , J.  A.  Seyrig1 , D.  Coumaros1 , C.  Claviere1 , A.  Bury1 , J.  Cottereau1 , J.  M.  Canard1 , S.  Chaussade1 , A.  Baudet1 , A.  Casteur1 , O.  Duval1 , T.  Ponchon1, of the OMEGA group
  • 1Observatoire de la Mucosectomie Endoscopique en Gastroenterologie (OMEGA), under the aegis of the Société Française d’Endoscopie Digestive (SFED), Paris, France
Further Information

Publication History

submitted 14 December 2009

accepted after revision 14 June 2010

Publication Date:
06 September 2010 (online)

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Commentaire de travail de D. Heresbach et al., pp. 806Endoscopy 2010; 42(10): 883-883
DOI: 10.1055/s-0032-1306718

Background and study aim: Studies on endoscopic mucosal resection (EMR) are mostly based on data from centers with high expertise. We report the average EMR results in a national survey of consecutive patients in France.

Methods: A 1-year survey was carried out to record immediate outcome data of all EMRs performed, regardless of lesion size or gastrointestinal location.

Results: Overall, 1335 EMRs in 1210 patients were reported by 241 of the 736 gastroenterologists who performed such procedures (33 %). Resections were done for upper gastrointestinal lesions in 125 cases (41 esophageal, 43 gastric, and 41 duodenal lesions), in 45 % of cases using specific EMR techniques such as ligation, cap, or traction. The technique for resecting the 1210 lower gastrointestinal lesions mostly consisted of saline-assisted polypectomy or EMR, with specific techniques used in only 2.2 %. En bloc resection was less common with esophageal (46 %) or duodenal (54 %) neoplasms than in the lower gastrointestinal tract (73 %); size also had some influence (53 % > 1 cm vs. 92 % ≤ 1 cm). The overall complication rate was 5.2 %; the rate was lower for lesions 1 cm or smaller (0.6 % vs. 4.6 %). Fifty-four early and 17 delayed complications were recorded, in 12 % of upper gastrointestinal and 4.6 % of colonic lesions. Surgery became necessary in 1.6 % for upper and 2.9 % for lower gastrointestinal neoplasms. No association was seen between physician EMR caseload and either en bloc resection rate or complication rate.

Conclusions: EMR in general, especially saline-assisted polypectomy in the colon, appears to be reasonably safe even when performed by nonexperts. EMR for larger or for upper gastrointestinal lesions should probably be limited to high-volume centers.

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D. HeresbachMD, PhD 

Service des Maladies de l’Appareil Digestif – CHU Pontchaillou

35033 – Rennes Cedex 09
France

Email: denis.heresbach@chu-rennes.fr

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