BACKGROUND: Endoscopic mucosal resection (EMR) is an effective therapeutic technique well-standardized worldwide for the treatment of gastrointestinal neoplasm limited to the mucosal layer. To date, no study has compared technical and clinical differences based on the number of EMRs performed per year. This study aimed to compare EMR technical success, complications, and clinical outcome between low-volume centers (LVCs) and high-volume centers (HVCs). A total of nine endoscopic centers were included in the study. METHODS: This prospective study investigated consecutive patients with sessile polyps or flat colorectal lesions 1 cm or larger referred for EMR. RESULTS: A total of 427 lesions were resected in 384 patients at nine endoscopic centers. Males accounted for 60.4% and females for 39.6% of the patients. Most of the EMRs (84.8%) were performed in HVCs and only 15.2% in LVCs. All the lesions were resected in only one session. Argon plasma coagulation was performed on the margins of piecemeal resection in 15.7% of the patients in HVCs only. Complete excision was achieved for 98.6% of the lesions in HVCs and 98.8% of the lesions in LVCs. The complication rate was 4.4% in HVCs and 4.6% in LVCs (p = 0.94). Delayed bleeding occurred in 2.5% of the HVC cases and 3.1% of the LVC cases. Perforation occurred in 1.9% of the HVC cases and 1.5% of the LVC cases (p = 1.00). Recurrences were experienced with 15% of the lesions: 15.5% in HVCs and 14% in LVCs (p = 0.79). CONCLUSIONS: The study showed that EMR can be performed also in LVC.
BACKGROUND: Endoscopic mucosal resection (EMR) is an effective therapeutic technique well-standardized worldwide for the treatment of gastrointestinal neoplasm limited to the mucosal layer. To date, no study has compared technical and clinical differences based on the number of EMRs performed per year. This study aimed to compare EMR technical success, complications, and clinical outcome between low-volume centers (LVCs) and high-volume centers (HVCs). A total of nine endoscopic centers were included in the study. METHODS: This prospective study investigated consecutive patients with sessile polyps or flat colorectal lesions 1 cm or larger referred for EMR. RESULTS: A total of 427 lesions were resected in 384 patients at nine endoscopic centers. Males accounted for 60.4% and females for 39.6% of the patients. Most of the EMRs (84.8%) were performed in HVCs and only 15.2% in LVCs. All the lesions were resected in only one session. Argon plasma coagulation was performed on the margins of piecemeal resection in 15.7% of the patients in HVCs only. Complete excision was achieved for 98.6% of the lesions in HVCs and 98.8% of the lesions in LVCs. The complication rate was 4.4% in HVCs and 4.6% in LVCs (p = 0.94). Delayed bleeding occurred in 2.5% of the HVC cases and 3.1% of the LVC cases. Perforation occurred in 1.9% of the HVC cases and 1.5% of the LVC cases (p = 1.00). Recurrences were experienced with 15% of the lesions: 15.5% in HVCs and 14% in LVCs (p = 0.79). CONCLUSIONS: The study showed that EMR can be performed also in LVC.
Authors: Gordon C Hunt; Walter J Coyle; Shireen A Pais; Douglas G Adler; Barry Degregorio; Christopher J Dimaio; Kulwinder S Dua; Brintha K Enestvedt; Linda S Lee; Lee McHenry; Daniel K Mullady; Elizabeth Rajan; Robert E Sedlack; Vanessa M Shami; William M Tierney; Ashley L Faulx Journal: Gastrointest Endosc Date: 2012-10 Impact factor: 9.427
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: Jim C Brooker; Brian P Saunders; Syed G Shah; Catherine J Thapar; Noriko Suzuki; Christopher B Williams Journal: Gastrointest Endosc Date: 2002-03 Impact factor: 9.427
Authors: S Tamura; K Nakajo; Y Yokoyama; K Ohkawauchi; T Yamada; Y Higashidani; T Miyamoto; H Ueta; S Onishi Journal: Endoscopy Date: 2004-04 Impact factor: 10.093
Authors: J Seidel; E Färber; R Baumbach; W Cordruwisch; U Böhmler; B Feyerabend; S Faiss Journal: Int J Colorectal Dis Date: 2016-01-12 Impact factor: 2.571
Authors: Thomas Worland; Oliver Cronin; Benjamin Harrison; Linda Alexander; Nik Ding; Alvin Ting; Stephanie Dimopoulos; Racheal Sykes; Sina Alexander Journal: Endosc Int Open Date: 2019-10-22