Standard "inject and Cut" Endoscopic Mucosal Resection Technique is Practical and Effective in the Management of Superficial Colorectal Neoplasms

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2008 Sep 23

PMID 18806938

Citations 11

Authors

Sanjiv Mahadeva

Bjorn J Rembacken

Affiliations

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Abstract

Background: Standard polypectomy techniques may be contributing to ineffective eradication of colonic superficial neoplasia, an increasing number of which are nonpolypoid. We aimed to demonstrate the practicality and efficacy of the "inject and cut" endoscopic mucosal resection (EMR) technique in routine clinical practice.

Methods: Colonic EMRs performed for polypoid and nonpolypoid lesions at a tertiary institution were prospectively collected and analyzed for efficacy, and short and long-term complications.

Results: 224 colonic neoplasms (143 flat, 65 sessile and 16 subpedunculated) were excised by the standard inject-and-cut method, with standard accessories. The median size of all lesions was 10 mm (range 2-50 mm) and 110 (49.2%) lesions were located in the proximal colon. Histological completeness of resection was achieved in 87% of cases. Of the lesions 77.2% were dysplastic, with 5 cases of carcinoma in situ and 18 severely dysplastic adenomas. Complications included bleeding in five cases (2.2 %) and a single case of perforation (0.4%). All complications were managed endoscopically. Median follow up at 24 +/- 16 months (range 12-84 months) revealed a 7.2% local recurrence rate, all of which were subsequently eradicated by repeat EMR.

Conclusions: Standard inject-and-cut colonic EMR is practical and effective in the eradication of superficial colonic neoplasia.

Citing Articles

Improving adherence towards bowel preparation for colonoscopy.

Mahadeva S JGH Open. 2023; 7(9):597-598.

PMID: 37744706 PMC: 10517440. DOI: 10.1002/jgh3.12975.

A Novel Bipolar Polypectomy Snare Can Be an Alternative Choice for Endoscopic Resection.

Chen S, Zhou D, Ruan R, Yu J, Li Y, Liu Y Front Med (Lausanne). 2021; 7:619844.

PMID: 33553214 PMC: 7855578. DOI: 10.3389/fmed.2020.619844.

Safety of endoscopic procedures with monopolar versus bipolar instruments in an ex vivo porcine model.

Shinmura K, Ikematsu H, Kojima M, Nakamura H, Osera S, Yoda Y BMC Gastroenterol. 2020; 20(1):27.

PMID: 32005163 PMC: 6995232. DOI: 10.1186/s12876-020-1176-9.

Size of colorectal polyps determines time taken to remove them endoscopically.

Kang H, Thoufeeq M Endosc Int Open. 2018; 6(5):E610-E615.

PMID: 29756019 PMC: 5943696. DOI: 10.1055/a-0587-4681.

Large Colorectal Lesions: Evaluation and Management.

Santos C, Pereira-Lima J, de Quadros Onofrio F GE Port J Gastroenterol. 2017; 23(4):197-207.

PMID: 28868460 PMC: 5580011. DOI: 10.1016/j.jpge.2016.01.001.

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