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Published on: February 13, 2026
Large endoscopic mucosal resection for colorectal tumors exceeding 4 cm
Philippe Ah Soune1, Charles Ménard, Ezzedine Salah
1Department of Gastroenterology, Hôpital Nord, Chemin des Bourrely, 13915 Marseille cedex 20, France.
World Journal of Gastroenterology
|February 4, 2010
Summary
Endoscopic mucosal resection (EMR) is a safe and effective treatment for large colorectal tumors over 4 cm. This piecemeal resection technique shows promising results, potentially rivaling other endoscopic methods.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Oncology
Background:
- Large colorectal tumors (>4 cm) pose challenges for endoscopic resection.
- Piecemeal endoscopic mucosal resection (EMR) is an alternative approach.
Purpose of the Study:
- To assess the feasibility and outcomes of piecemeal EMR for large colorectal tumors (LCRTs) exceeding 4 cm.
- To evaluate the safety and efficacy of EMR in managing LCRTs.
Main Methods:
- Retrospective analysis of 26 LCRTs treated with piecemeal EMR between January 2005 and April 2008.
- Tumors were characterized by size, location, Paris classification, and pathology.
- Follow-up duration averaged 12 months.
Main Results:
- LCRTs were predominantly located in the rectum (58%). Mean tumor size was 4.9 cm.
- Histopathology revealed adenomas and high-grade dysplasia in most cases.
- Procedural bleeding occurred in 7.7% of cases, managed endoscopically. Tumor recurrence was observed in 12% of patients.
Conclusions:
- Piecemeal EMR is a safe and effective endoscopic treatment for large colorectal tumors (>4 cm).
- EMR offers a viable alternative to other endoscopic techniques like endoscopic submucosal dissection.
- While effective, EMR may provide incomplete histological assessment.
