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Endoscopic mucosal resection for colonic non-polypoid neoplasms.
Ming-Yao Su1, Chen-Ming Hsu, Yu-Pin Ho
1Digestive Therapeutic Endoscopic Center, Department of Gastroenterology, Chang-Gung Memorial Hospital, Linkou Medical Center, Chang-Gung University, Taiwan, ROC.
The American Journal of Gastroenterology
|September 27, 2005
Summary
Endoscopic mucosal resection (EMR) effectively removes non-polypoid colonic lesions, providing integral specimens for pathology. This minimally invasive technique is safe and efficient for managing these high-risk tumors.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Oncology
Background:
- Non-polypoid colonic lesions possess higher malignant potential than polypoid types.
- Accurate histopathology of resected lesions is crucial for patient management.
- Endoscopic mucosal resection (EMR) offers a minimally invasive alternative to surgery for these lesions.
Purpose of the Study:
- To assess the safety and efficacy of EMR for non-polypoid colonic lesions.
- To evaluate the clinical outcomes of EMR in obtaining integral specimens.
Main Methods:
- 152 non-polypoid colonic neoplasms in 149 patients were treated with EMR between 2000 and 2003.
- Lesions were identified via magnification colonoscopy with indigo carmine dye spray.
- EMR utilized pure cutting current, followed by hemoclip application to resected wounds.
Main Results:
- Complete resection was achieved for 40 flat lesions, 106 lateral spreading tumors, and 6 depressed lesions (mean size 19.4 mm).
- Histological findings included 4 adenocarcinomas, 59 high-grade adenomas/dysplasias, and 89 low-grade adenomas/dysplasias.
- Two immediate post-EMR bleeding events were managed with hemoclips; no delayed bleeding or perforation occurred.
Conclusions:
- EMR using pure cutting current and hemoclips is effective for obtaining integral specimens for accurate pathologic assessment.
- This technique provides a safe and minimally invasive approach for managing colonic non-polypoid lesions.