Treatment of adenoma recurrence after endoscopic mucosal resection
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View abstract on PubMed
Summary
This summary is machine-generated.Residual adenoma after colorectal polyp removal is common but effectively treated with endoscopic retreatment. Most patients achieve long-term remission, avoiding surgery and complex procedures.
Area Of Science
- Gastroenterology
- Endoscopic Surgery
- Colorectal Cancer Prevention
Background
- Residual or recurrent adenoma (RRA) after endoscopic mucosal resection (EMR) of large non-pedunculated colorectal polyps (LNPCPs) is a significant clinical challenge.
- Current data on endoscopic retreatment outcomes for RRA are limited, lacking established evidence-based standards.
Purpose Of The Study
- To investigate the efficacy and long-term outcomes of endoscopic retreatment for residual or recurrent adenoma following EMR of LNPCPs.
- To evaluate the success rates and need for further interventions after endoscopic therapy for RRA.
Main Methods
- Prospective cohort study over 139 months, recording data on RRA detected after EMR for LNPCPs (≥20 mm).
- Endoscopic retreatment predominantly utilized hot snare resection, cold avulsion forceps with soft coagulation, or a combination.
- Follow-up colonoscopies assessed treatment success and need for further procedures.
Main Results
- RRA occurred in 14.6% of patients, commonly small (2.5-5.0 mm) and unifocal.
- Successful endoscopic therapy was achieved in 96.0% of cases with macroscopic RRA.
- Long-term adenoma remission exceeded 90% with a mean of 1.15 retreatment sessions; only 4.2% required surgery.
Conclusions
- Simple endoscopic techniques are highly effective for treating RRA after LNPCP EMR, achieving >90% long-term remission.
- Endoscopic retreatment minimizes the need for more complex, morbid, or resource-intensive procedures.
- This approach offers a safe and effective standard for managing RRA.
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