BACKGROUND: Endoscopic piecemeal mucosal resection (EPMR) is a widely accepted treatment for colorectal tumefaction. However, as it is associated with a significant recurrence rate, the technique remains controversial. The purpose of our study was to evaluate the risk factors for the local recurrence of colorectal neoplasms after EPMR. METHODS: The study population of our retrospective evaluation comprised 222 patients who had undergone EPMR from January 2002 to July 2007 and who had had at least 1 surveillance colonoscopy 3-6 months after the initial treatment. RESULTS: Local recurrence was detected in 42 patients (19%) between 6 and 15 months after EPMR. Our multivariate analysis revealed that the resection of 5 or more neoplasm specimens, compared with fewer than 5, was 3 times more likely to result in local recurrence (P = 0.005). No statistically significant correlation of local recurrence with lesion size, location, macroscopic type, or histology was detected. CONCLUSION: The removal of 5 or more neoplasm specimens is an independent risk factor for local recurrence after EPMR. Careful colonoscopic surveillance should be performed after multiple piecemeal resection.
BACKGROUND: Endoscopic piecemeal mucosal resection (EPMR) is a widely accepted treatment for colorectal tumefaction. However, as it is associated with a significant recurrence rate, the technique remains controversial. The purpose of our study was to evaluate the risk factors for the local recurrence of colorectal neoplasms after EPMR. METHODS: The study population of our retrospective evaluation comprised 222 patients who had undergone EPMR from January 2002 to July 2007 and who had had at least 1 surveillance colonoscopy 3-6 months after the initial treatment. RESULTS: Local recurrence was detected in 42 patients (19%) between 6 and 15 months after EPMR. Our multivariate analysis revealed that the resection of 5 or more neoplasm specimens, compared with fewer than 5, was 3 times more likely to result in local recurrence (P = 0.005). No statistically significant correlation of local recurrence with lesion size, location, macroscopic type, or histology was detected. CONCLUSION: The removal of 5 or more neoplasm specimens is an independent risk factor for local recurrence after EPMR. Careful colonoscopic surveillance should be performed after multiple piecemeal resection.
Authors: S Tanaka; K Haruma; S Oka; R Takahashi; M Kunihiro; Y Kitadai; M Yoshihara; F Shimamoto; K Chayama Journal: Gastrointest Endosc Date: 2001-07 Impact factor: 9.427
Authors: Sidney J Winawer; Ann G Zauber; Robert H Fletcher; Jonathon S Stillman; Michael J O'Brien; Bernard Levin; Robert A Smith; David A Lieberman; Randall W Burt; Theodore R Levin; John H Bond; Durado Brooks; Tim Byers; Neil Hyman; Lynne Kirk; Alan Thorson; Clifford Simmang; David Johnson; Douglas K Rex Journal: Gastroenterology Date: 2006-05 Impact factor: 22.682
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Authors: Andrew Y Wang; Mary M Flynn; James T Patrie; Dawn G Cox; Wissam Bleibel; James A Mann; Bryan G Sauer; Vanessa M Shami Journal: Surg Endosc Date: 2014-04 Impact factor: 4.584