AIM: Lateral spreading tumors (LST) are relatively large flat lesions with diameters exceeding 10 mm in length. Endoscopic mucosal resection (EMR) is a commonly used technique for removing LST. We aimed to evaluate the risk factors for incomplete resection and complications of EMR for LST. METHOD: Between January 2004 and December 2010, 497 patients who underwent EMR for LST were retrospectively reviewed. Risk factors for endoscopic and histopathological complete resection, complications, and clinical outcomes were investigated. RESULTS: Risks for incomplete resection by piecemeal resection and en bloc resection of a lesion ≥ 30 mm were higher than for en bloc resection of a lesion <30 mm (OR=2.688, CI 1.036-6.993; OR=4.982, CI 1.894-13.101). Risks of post-EMR bleeding for piecemeal resection and en bloc resection for a lesion ≥ 40 mm were higher than for en bloc resection of a lesion <40 mm (OR=15.231, CI 1.816-127.744; OR=43.043, CI 4.306-430.314). CONCLUSION: We found risk factors of EMR for LST and tentatively suggest a protocol for EMR adapted to the size of LST and resection methods. (i) Following piecemeal resection and en bloc resection for LST ≥ 40 mm, hospitalize patients for 36 h and note risk for incomplete resection and delayed bleeding. (ii) After en bloc resection for 40 mm>LST ≥ 30 mm, hospitalize patients for 12 h and note risk for incomplete resection. (iii) Following en bloc resection for LST<30 mm, hospitalize the patient for 12 h and expect complete resection.
AIM: Lateral spreading tumors (LST) are relatively large flat lesions with diameters exceeding 10 mm in length. Endoscopic mucosal resection (EMR) is a commonly used technique for removing LST. We aimed to evaluate the risk factors for incomplete resection and complications of EMR for LST. METHOD: Between January 2004 and December 2010, 497 patients who underwent EMR for LST were retrospectively reviewed. Risk factors for endoscopic and histopathological complete resection, complications, and clinical outcomes were investigated. RESULTS: Risks for incomplete resection by piecemeal resection and en bloc resection of a lesion ≥ 30 mm were higher than for en bloc resection of a lesion <30 mm (OR=2.688, CI 1.036-6.993; OR=4.982, CI 1.894-13.101). Risks of post-EMR bleeding for piecemeal resection and en bloc resection for a lesion ≥ 40 mm were higher than for en bloc resection of a lesion <40 mm (OR=15.231, CI 1.816-127.744; OR=43.043, CI 4.306-430.314). CONCLUSION: We found risk factors of EMR for LST and tentatively suggest a protocol for EMR adapted to the size of LST and resection methods. (i) Following piecemeal resection and en bloc resection for LST ≥ 40 mm, hospitalize patients for 36 h and note risk for incomplete resection and delayed bleeding. (ii) After en bloc resection for 40 mm>LST ≥ 30 mm, hospitalize patients for 12 h and note risk for incomplete resection. (iii) Following en bloc resection for LST<30 mm, hospitalize the patient for 12 h and expect complete resection.
Authors: Matthew D Rutter; Amit Chattree; Jamie A Barbour; Siwan Thomas-Gibson; Pradeep Bhandari; Brian P Saunders; Andrew M Veitch; John Anderson; Bjorn J Rembacken; Maurice B Loughrey; Rupert Pullan; William V Garrett; Gethin Lewis; Sunil Dolwani Journal: Gut Date: 2015-06-23 Impact factor: 23.059
Authors: Seong Ji Choi; Hong Sik Lee; Jiyeong Kim; Jung Wan Choe; Jae Min Lee; Jong Jin Hyun; Jai Hoon Yoon; Hyo Jung Kim; Jae Seon Kim; Ho Soon Choi Journal: World J Gastroenterol Date: 2022-05-07 Impact factor: 5.374
Authors: Oliver Bendall; Joel James; Katarzyna M Pawlak; Sauid Ishaq; J Andy Tau; Noriko Suzuki; Steven Bollipo; Keith Siau Journal: Clin Exp Gastroenterol Date: 2021-12-24