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Related Concept Videos

Peptic Ulcer Disease IV: Management01:26

Peptic Ulcer Disease IV: Management

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Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
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Related Experiment Video

Updated: May 6, 2026

Evaluation of the Effectiveness of Longitudinal Incision for Endoscopic Submucosal Excavation of Gastric Subepithelial Lesions
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Recurrence after endoscopic mucosal resection-therapy failure?

S Belle1, L Haase, L R Pilz

  • 1University Medical Centre, Mannheim Heidelberg University, Mannheim, Germany, sebastianbelle@me.com.

International Journal of Colorectal Disease
|October 23, 2013
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Summary
This summary is machine-generated.

Endoscopic mucosal resection (EMR) effectively removes large flat adenomas. Recurrence is possible but manageable, with resection technique and histology influencing outcomes.

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Oncology

Background:

  • Large flat adenomas pose challenges for complete endoscopic resection.
  • Endoscopic mucosal resection (EMR) is a key technique for managing these lesions.
  • Assessing EMR success and recurrence factors is crucial for patient management.

Purpose of the Study:

  • To evaluate the success and complication rates of EMR for large flat adenomas (>10 mm, Paris 0-Is, 0-IIa-c).
  • To identify risk factors associated with adenoma recurrence after EMR.
  • To assess the long-term efficacy of EMR in achieving adenoma clearance.

Main Methods:

  • Retrospective analysis of 177 EMR procedures performed between 2003 and 2005.
  • Inclusion criteria: adenoma size >10 mm, Paris 0-Is/0-IIa-c, and endoscopic follow-up.
  • Univariate and multivariate logistic regression analyses were used to identify influencing factors.

Main Results:

  • A median follow-up of 6 years was analyzed for 177 EMRs (mean size 21 mm), primarily in the right colon.
  • Recurrence was observed in 29 patients (16.4%), with most managed endoscopically.
  • Multivariate analysis identified resection technique, immediate complications, age, and histology as significant factors.

Conclusions:

  • EMR is a successful method for achieving long-term clearance of large flat adenomas.
  • Recurrence after EMR does not signify treatment failure and necessitates careful follow-up.
  • Procedural assessment of resection effectiveness and technique are vital for stratifying follow-up strategies.