Efficacy and safety of cap-assisted endoscopic mucosal resection for treatment of nonlifting colorectal polyps
- 14 September 2021
- journal article
- research article
- Published by Georg Thieme Verlag KG in Endoscopy
- Vol. 54 (05), 509-514
- https://doi.org/10.1055/a-1559-2391
Abstract
Background Suboptimal lifting increases complexity of endoscopic mucosal resection (EMR) for benign colorectal polyps. Cap-assisted EMR (EMR-C) may allow fibrotic polyp tissue to be captured in the snare. This study evaluated the efficacy and safety of EMR-C for benign nonlifting colorectal polyps. Methods This was a multicenter study, which prospectively registered all EMR-C procedures (2016–2018) for presumed benign nonlifting colorectal polyps. Results 70 nonlifting polyps with a median size of 25 mm (interquartile range [IQR] 15–40) were treated with EMR-C. Complete polyp removal was achieved in 68 (97.1 %), including 47 (67.1 %) with EMR-C alone. Overall, 66 polyps showed benign histology, and endoscopic follow-up after a median of 6 months (IQR 6–10) showed recurrence in 19.7 %. First (n = 10) and second (n = 2) benign recurrences were all treated endoscopically. Deep mural injury type III–V occurred in 7.4 % and was treated successfully with clips. Conclusion EMR-C may be an alternative therapeutic option for removal of benign nonlifting polyp tissue. Although recurrence still occurs, repeat endoscopic therapy usually leads to complete polyp clearance. Received: 12 November 2020 Accepted after revision: 03 July 2021 Publication Date: 14 September 2021 (online) © 2021. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyThis publication has 15 references indexed in Scilit:
- Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical GuidelineEndoscopy, 2017
- Deep mural injury and perforation after colonic endoscopic mucosal resection: a new classification and analysis of risk factorsGut, 2016
- Avulsion is superior to argon plasma coagulation for treatment of visible residual neoplasia during EMR of colorectal polyps (with videos)Gastrointestinal Endoscopy, 2016
- Cap-assisted Endoscopic Mucosal Resection is Highly Effective for Nonpedunculated Colorectal LesionsJournal of Clinical Gastroenterology, 2016
- Effect of prior biopsy sampling, tattoo placement, and snare sampling on endoscopic resection of large nonpedunculated colorectal lesionsGastrointestinal Endoscopy, 2015
- Hot avulsion: a modification of an existing technique for management of nonlifting areas of a polyp (with video)Gastrointestinal Endoscopy, 2014
- Underwater endoscopic mucosal resection for recurrences after previous piecemeal resection of colorectal polyps (with video)Gastrointestinal Endoscopy, 2014
- Long-term adenoma recurrence following wide-field endoscopic mucosal resection (WF-EMR) for advanced colonic mucosal neoplasia is infrequent: results and risk factors in 1000 cases from the Australian Colonic EMR (ACE) studyGut, 2014
- Risk Factors for Intraprocedural and Clinically Significant Delayed Bleeding After Wide-field Endoscopic Mucosal Resection of Large Colonic LesionsClinical Gastroenterology and Hepatology, 2013
- Lifting of Lesions During Endoscopic Mucosal Resection (EMR) of Early Colorectal Cancer: Implications for the Assessment of ResectabilityEndoscopy, 2001