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Is it safe for endoscopic piecemeal mucosal resection in treating large sessile colorectal polyps?

Date:
June 24, 2010
Source:
World Journal of Gastroenterology
Summary:
Endoscopic removal of colonic adenomatous polyps is a commonly used technique that reduces the incidence of colorectal cancer. A research group at the National Cancer Center, Korea revealed that endoscopic piecemeal mucosal resection can be used safely for large sessile colorectal polyps, but should be applied carefully in malignant polyps due to high recurrence rate.

Endoscopic resection of large sessile colorectal polyps is increasingly used as an alternative to surgery, but remains challenging because of its technical difficulty, the high risk of complications such as bleeding or perforation, and the possibility of coexisting malignancy.

This research, lead by Dr. Sohn DK and his colleagues at the National Cancer Center, Korea, demonstrated the safety of endoscopic piecemeal resection (EPMR) for large sessile colorectal polyps and the research has recently been published on June 14, 2010 in the World Journal of Gastroenterology. The authors included a large number of polyps with significant numbers of malignancies and were able to demonstrate that relapse was low in patients with benign polyps after endoscopic resection.

The research group enrolled 47 patients with 50 large sessile polyps (2 cm or greater in diameter) who underwent EPMR using a submucosal saline injection technique and observed them during follow-up examinations over a median period of 37 months. They showed that 12% of patients had procedure-related minor bleeding. No perforations were observed. Recurrence was identified in 5 cases (12.2%). The significant finding of this research is that the incidence of recurrence after EPMR in malignant lesions was higher than that in benign lesions (33.3% vs 3.1%).

It is still difficult to explain the reason why the incidence of recurrence after EPMR in malignant lesions was higher than that in benign lesions. However, the authors suggested that the endoscopist should try to remove all cancer cells completely because microscopic residual cancer cells after EPMR can cause recurrences. They also suggested that EPMR should be applied carefully in malignant polyps, and close follow-up endoscopic examinations are necessary for early detection of recurrence.


Story Source:

The above story is based on materials provided by World Journal of Gastroenterology. Note: Materials may be edited for content and length.


Journal Reference:

  1. Seo GJ, Sohn DK, Han KS, Hong CW, Kim BC, Park JW, Choi HS, Chang HJ, Oh JH. Recurrence after endoscopic piecemeal mucosal resection for large sessile colorectal polyps. World Journal of Gastroenterology, 2010; 16 (22): 2806 DOI: 10.3748/wjg.v16.i22.2806

Cite This Page:

World Journal of Gastroenterology. "Is it safe for endoscopic piecemeal mucosal resection in treating large sessile colorectal polyps?." ScienceDaily. ScienceDaily, 24 June 2010. <www.sciencedaily.com/releases/2010/06/100624104526.htm>.
World Journal of Gastroenterology. (2010, June 24). Is it safe for endoscopic piecemeal mucosal resection in treating large sessile colorectal polyps?. ScienceDaily. Retrieved August 1, 2014 from www.sciencedaily.com/releases/2010/06/100624104526.htm
World Journal of Gastroenterology. "Is it safe for endoscopic piecemeal mucosal resection in treating large sessile colorectal polyps?." ScienceDaily. www.sciencedaily.com/releases/2010/06/100624104526.htm (accessed August 1, 2014).

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