Endoscopic mucosal resection in high- and low-volume centers: a prospective multicentric study

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Endoscopic mucosal resection (EMR) is a standard treatment for gastrointestinal neoplasms confined to the mucosal layer.
• No prior studies have compared EMR outcomes based on annual procedure volume.
• This research addresses the technical and clinical differences in EMR between low-volume centers (LVCs) and high-volume centers (HVCs).

Purpose of the Study:

• To compare the technical success, complication rates, and clinical outcomes of endoscopic mucosal resection (EMR) performed in low-volume centers (LVCs) versus high-volume centers (HVCs).

Main Methods:

• A prospective study involving nine endoscopic centers.
• Consecutive patients with sessile polyps or flat colorectal lesions (≥1 cm) referred for EMR were investigated.
• Data on lesion resection, complications, and recurrence were collected and analyzed.

Main Results:

• A total of 427 lesions were resected in 384 patients across nine centers.
• Complete excision rates were high and comparable: 98.6% in HVCs and 98.8% in LVCs.
• Complication rates (4.4% vs. 4.6%), delayed bleeding (2.5% vs. 3.1%), perforation (1.9% vs. 1.5%), and recurrence rates (15.5% vs. 14%) were similar between HVCs and LVCs.

Conclusions:

• Endoscopic mucosal resection (EMR) demonstrates comparable efficacy and safety regardless of procedural volume.
• Low-volume centers (LVCs) can achieve successful EMR outcomes similar to high-volume centers (HVCs).
• This suggests that EMR is a viable option in diverse healthcare settings.